Τετάρτη 13 Οκτωβρίου 2021

Preoperative SARS‐CoV‐2 Screening Fails to Detect Viral Particles Prior to Airway Surgery

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Abstract

Objectives

Children have higher rates of asymptomatic SARS-CoV-2 infections or milder courses of infection, and their carrier status may potentially impact viral transmission to those providing them care. The aim of this study is to compare the existing COVID-19 pre-operative screening protocols to the detection of SARS-CoV-2 viral particles in surgical samples.

Methods

We conducted a prospective study with consecutive convenience sampling of children undergoing adenoidectomy between January and April 2021. Total nucleic acid was extracted from adenoid tissue and real-time reverse transcription-polymerase chain reaction was conducted to test for presence of SARS-CoV-2 viral particles. Univariate logistic regression was used to summarize the effect size of variables of interest on the odds of having SARS-CoV-2 positive adenoid tissue.

Results

Forty adenoid samples were collected and 11 (27.5%) had a positive SARS-CoV-2 reverse transcriptase- polymerase chain reaction. Patients with positive adenoids were older (11.8 years vs 7.9 years, OR: 1.3, p=0.01) and more likely to have had a positive nasopharyngeal swab in the previous 90 days (4/11 or 36% vs 0).

Conclusion

This data is the first report on the presence of SARS-CoV-2 particles in pediatric adenoidectomy specimens, with a high percentage of patients showing evidence of viral particles within the adenoid. This finding calls in to question the utility of preoperative COVID screening protocols which have yet to be rigorously validated in asymptomatic patients and have the potential to delay patients' surgical care.

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