Incidence and Clinical Profiles of COVID-19 In Patients with Gynecological Surgery. A Single Center Descriptive Study from Spain

Background: The inflammatory reaction after a surgical intervention could exacerbate the course of the COVID-19. We aim to determine the rate of COVID-19 and its complications among gynecological surgeries in the context of different measures taken during the pandemic period in our department.

Methods: A retrospective longitudinal observational study was conducted. Clinical records of patients who underwent gynecological surgery from March 1st to April 10th, 2020 were reviewed. During this period, three different approaches were made: first phase, without any screening or surgical restrictions; second phase, with presurgical epidemiological screening using a specific questionnaire; and third phase, also with presurgical SARS-COV-19 RT-PCR. During the second and third phases the surgical activity and complexity were restricted, and different workflows were established for patient with suspected/confirmed infection. After hospital discharge, telephone follow-up was performed and screening for COVID-19 was carried out. Complications from the disease were analyzed.

Results: Of the 118 patients that underwent gynecological surgeries, 10 (8.5%) were perioperatively diagnosed with COVID-19. Of these patients, 8 (80%) were not pre-surgical screened for SARS-CoV-2 infection, neither clinical nor with RT-PCR. The other 2 (20%) were preoperative screened with RT-PCR, one of them with a positive test result. Screening false negative rate was 0.8%. No postoperative complications derived from COVID-19 were observed.

Conclusions: The establishment of different surgical workflows, the reduction of surgical complexity, and the use of a pre-surgical screening to detect patient at SARS-CoV-2 infection risk, could reduce the postoperative complications derived from that infection and improve surgical outcomes.

Keywords: COVID-19; SARS-cov-2; Surgery; Gynecology

Abstract: COVID-19: Coronavirus Disease; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; R0: Basic Reproductive Number; ARDS: Acute Respiratory Distress Syndrome; ICU: Intensive Care Unit; RT-PCR: Quantitative RNA by Reverse Transcription Polymerase Chain Reaction; IQR: Interquartile Range