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CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(05): 261-265
DOI: 10.1055/s-0043-1770129
Original Article
Covid

Existence of SARS-Cov-2 in the Peritoneal Fluid

Existência de SARS-Cov-2 no líquido peritoneal
Orkun Ilgen 
1   Gynecologic Oncology Clinic, Erzurum City Hospital, Erzurum, Turkey
,
Mehmet Eyuphan Ozgozen 
2   Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey
,
Ozgur Appak 
3   Department of Microbiology, Dokuz Eylul University School of Medicine, Izmir, Turkey
,
Begum Ertan 
4   Obstetrics and Gynecology Clinic, Sandikli State Hospital, Afyon, Turkey
,
Hikmet Tunc Tımur 
5   Obstetrics and Gynecology Clinic, Urla State Hospital, Izmir, Turkey
,
Omer Erbil Dogan 
2   Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey
,
Cemal Posacı 
2   Department of Obstetrics and Gynecology, Dokuz Eylul University School of Medicine, Izmir, Turkey
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Abstract

Objective To determine the existence of SARS-CoV-2 in the peritoneal fluid to assess the risk of exposure through surgical smoke and aerosolization threatening healthcare workers during abdominal surgery.

Background SARS-CoV-2 is a respiratory virus and possible ways of viral transmission are respiratory droplets, close contact, and fecal-oral route. Surgeries pose risk for healthcare workers due to the close contact with patients. Aerosolized particles may be inhaled via the leaked CO2 during laparoscopic procedures and surgical smoke produced by electrocautery.

Methods All the data of 8 patients, who were tested positive for COVID–19, were collected between August 31, 2020 and April 30, 2021. Recorded clinicopathologic data included age, symptoms, radiological and laboratory findings, antiviral treatment before surgery, type of surgery and existence of the virus in the peritoneal fluid. Nasopharyngeal swab RT-PCR was used for the diagnosis. COVID–19 existence in the peritoneal fluid was determined by RT-PCR test as well.

Results All 8 COVID–19 positive patients were pregnant, and surgeries were cesarean sections. 1 of the 8 patients was febrile during surgery. Also only 1 patient had pulmonary radiological findings specifically indicating COVID-19 infection. Laboratory findings were as follows: 4 of 8 had lymphopenia and all had elevated D-dimer levels. Peritoneal and amniotic fluid samples of all patients were negative for SARS-CoV-2.

Conclusion SARS-CoV-2 exposure due to aerosolization or surgical fumes does not seem to be likely, provided the necessary precautions are taken.

Resumo

Objetivo Determinar a existência de SARS-CoV-2 no fluido peritoneal para avaliar o risco de exposição através da fumaça cirúrgica e aerossolização que ameaçam os profissionais de saúde durante a cirurgia abdominal.

Contexto O SARS-CoV-2 é um vírus respiratório e as possíveis formas de transmissão viral são gotículas respiratórias, contato próximo e rota fecal-oral. As cirurgias representam risco para os profissionais de saúde devido ao contato próximo com os pacientes. As partículas aerossolizadas podem ser inaladas através do CO2 vazado durante os procedimentos laparoscópicos e a fumaça cirúrgica produzida pela eletrocauterização.

Métodos Todos os dados de 8 pacientes, que foram testados positivos para COVID-19, foram coletados entre 31 de agosto de 2020 e 30 de abril de 2021. Dados clinicopatológicos registrados incluíam idade, sintomas, achados radiológicos e laboratoriais, tratamento antiviral antes da cirurgia, tipo de cirurgia e existência do vírus no fluido peritoneal. O diagnóstico foi feito através do swab nasofaríngeo RT-PCR. A existência de COVID-19 no fluido peritoneal foi determinada pelo teste de RT-PCR também.

Resultados Todas as 8 pacientes positivas para COVID-19 estavam grávidas, e as cirurgias eram cesarianas. 1 das 8 pacientes estava com febre durante a cirurgia. Também apenas 1 paciente tinha achados radiológicos pulmonares especificamente indicando infecção por COVID-19. Os achados laboratoriais foram os seguintes: 4 de 8 tinham linfopenia e todas apresentavam níveis elevados de D-dímero. Amostras de fluido peritoneal e líquido amniótico de todas as pacientes foram negativas para SARS-CoV-2.

Conclusão A exposição ao SARS-CoV-2 devido à aerossolização ou fumaças cirúrgicas não parece ser provável, desde que sejam tomadas as precauções necessárias.

Keywords

SARS-CoV-2 - peritoneal fluid - surgical smoke - amniotic fluid - COVID-19

Palavras-chave

SARS-CoV-2 - fluido peritoneal - fumaça cirúrgica - líquido amniótico - COVID-19

Contributions

OI: conception and design, analysis and interpretation of data, statistical analysis MEO: acquisition of data, drafting of manuscript OA: acquisition of data, technical support BE: analysis and interpretation of data HTT: drafting of the manuscript OED: critical revision of the manuscript for important intellectual CP: supervision




Publication History

Received: 02 March 2022

Accepted: 22 March 2023

Article published online:
20 June 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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