Outcomes of Preoperative Testing for SARS-CoV-2 in Otolaryngology
Surgery during the Pandemic
Abstract
Objective: Preoperative testing for COVID-19 has become widely
established to avoid inadvertent surgery on patients with COVID-19 and
prevent hospital outbreaks, however, there is limited evidence
underpinning new protocols. We wished to study the effectiveness of
preoperative COVID-19 testing during and after the first wave of the
pandemic in Ireland. Design Prospective cohort study. Setting: 2
university hospitals in the Republic of Ireland. Participants: Patients
undergoing otolaryngology surgery and the otolaryngologists performing
surgery. Main outcome measure: Incidence of COVID-19 within 30 days of
surgery. Results: 173 patients (56% male) were recruited. 123 (71%)
patients “cocooned” for 14 days prior to surgery. All patients
completed a questionnaire prior to hospital admission. 156 patients
(90%) had reverse transcriptase-polymerase chain reaction (RTPCR)
nasopharyngeal swabs, 14 patients (8%) had CT thorax. No cases of
COVID-19 were detected among patients followed up at 30 days. Two
surgeons developed COVID-19 early during the study period not considered
to be related directly to contact within the hospital. Conclusion:
Current pre-operative testing protocols consisting primarily of
questionnaires and RT-PCR resulted in zero cases of COVID reported in
this cohort. It is possible that COVID-19 restrictions and high
proportion of patients cocooning preoperatively were factors in ensuring
a low rate of COVID-19 postoperatively. Ongoing data collection is
required to confirm these findings in the setting of further disease
surges.