Safe return to elective surgery following a COVID-19 outbreak: an observational study

Abstract Background It is a challenging task to resume suspended surgical services following coronavirus disease 2019 (COVID-19) outbreaks. We aimed to investigate the results of the pre-admission screening for patients awaiting surgery during the COVID-19 pandemic. Methods This retrospective study enrolled consecutive 100 patients who underwent surgical procedures under general anesthesia at a single institution in May 2020. For 2 weeks prior to admission, patients were required to avoid nonessential outings and record symptoms and temperatures every day. On the day before admission, real-time polymerase chain reaction (PCR) and chest computed tomography (CT) were performed. Results Pre-admission PCRs were all negative, and no CT imaging suggested COVID-19 infection, combined with clinical information. As a result, all surgeries were performed as scheduled. No virus was detected from the extubated tracheal tubes in operating rooms. No patients developed COVID-19 infection postoperatively. No nosocomial infection was reported through the study period and for 1 month thereafter. Conclusions With 2-week avoidance of nonessential outings before admission for surgery, combined with reverse transcriptase PCR and chest CT shortly before admission, we successfully resumed elective surgeries, confirmed by PCR of extubated tracheal tube swabs, at a hospital that experienced a COVID-19 outbreak.