key: cord-299489-6v225vte
authors: Gómez-Hernández, María Teresa; Novoa, Nuria M.; Antúnez, Patricia; Jiménez, Marcelo F.
title: TWICE LUCKY: ELDERLY PATIENT SURVIVING BOTH COVID-19 AND SERENDIPITOUS LUNG CARCINOMA
date: 2020-07-25
journal: Arch Bronconeumol
DOI: 10.1016/j.arbres.2020.07.009
sha: 
doc_id: 299489
cord_uid: 6v225vte

nan

To avoid virus spread, the procedure to transfer a patient from one to another hospital must follow all security protocols. So that, before transferring the patient we performed a new PCR test with a negative result. Once here, since the patient had not complied the 14 days of individual isolation after discharge, a serologic test was ordered to verify if the infection was active or passed; the result was positive, but unfortunately there was no possibility to know about which kind of immunoglobulins was elevated (Ig G or Ig M) due to the lack of reactants.

So that, a new PCR test was performed to confirm the previous one with a delay less than 48 hours. The result was negative. Regarding the two last negative tests and the time interval since the first positive test (more than three weeks), the patient was considered as a SARS-CoV-2 negative patient and treated with comprehensive protective measures but without strict isolation in the ward. 19 is associated with poor prognosis for patients undergoing thoracic operation, especially for those with COPD. So that, unnecessary thoracic surgeries should be avoided. Besides, since it is imperative to ensure the safety of health-care workers not only to safeguard continuous patient care but also to ensure they do not transmit the virus, high-sensibility diagnostic tests should be routinely performed to identify current and past infection (serologic tests) and to ensure that patients who have overcome the disease are no longer contagious (nucleic acid tests).

Until a few days ago, only urgent procedures and high priority oncological elective surgery in non-COVID-19 patients were performed and always balancing the risk of delaying therapy against the availability of hospital resources and potential exposure of COVID-19 on a case-bycase basis. In addition, whenever possible, the elective surgical activity has been transferred to COVID-free areas to avoid potential contracting intra-hospital infections. Since previous reports have revealed that there are asymptomatic patients infected with SARS-CoV-2 (4,5), all patients needing a surgical intervention should be tested.

We report the case of a patient presented with left spontaneous pneumothorax after discharge for COVID-19 pneumonia that was managed surgically. We consider this therapy was nondelayable and, after microbiological verification of SARS-CoV-2 negativity, excision of a perforated bulla was performed. Pathological examination of the specimen revealed a lung carcinoma in situ whose prognosis is excellent.

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. The Lancet. 2020;S014067362031182X

Clinical and Transmission Characteristics of Covid-19 -A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department

Protecting health-care workers from subclinical coronavirus infection

Presumed Asymptomatic Carrier Transmission of COVID-19

Microscopical detailed view of atypical cellularity with a high mitotic index (squamous cell carcinoma)