key: cord-300024-169g2ih5
authors: Flemming, S.; Hankir, M.; Hering, I.; Meybohm, P.; Krone, M.; Weissbrich, B.; Germer, C.T.; Wiegering, A.
title: Abdominal fluid samples (negative for SARS‐CoV‐2) from a critically unwell patient with respiratory COVID‐19
date: 2020-05-26
journal: Br J Surg
DOI: 10.1002/bjs.11713
sha: 
doc_id: 300024
cord_uid: 169g2ih5

nan

knowledge indicating that SARS-CoV-2 spreads mainly through respiratory droplets, it is entirely unclear if SARS-CoV-2 can spread to the peritoneal cavity or other bodily fluids 4 . This is especially relevant for surgery involving electrocautery, lasers or ultrasonic scalpels because viruses (including hepatitis B, hepatitis C and human immunodeficiency virus) spread through gaseous by-products commonly referred to as 'surgical smoke'.

Abdominal fluid (ascites), bile, liver and gall bladder samples were collected during emergency cholecystectomy of a critically ill patient suffering from COVID-19. Tracheal secretion and throat swab samples were collected immediately prior to surgery as positive controls. All samples were tested for SARS-CoV-2 by real-time reverse transcriptase polymerase chain reaction (PCR) using validated primers 5 . PCR tests revealed strongly positive results for SARS-CoV-2 RNA in tracheal secretion as well as in throat swab samples, with cycle threshold values of 20 and 25, respectively. The remaining samples all tested negative for SARS-CoV-2 suggesting that the virus does not spread to the abdominal cavity, bile and abdominal organs. A stool sample obtained one day after surgery also tested negative.

These preliminary findings suggest that the potential infectious risk for operating theatre staff and surgeons during open and laparoscopic operations in SARS-CoV-2 patients is lower than initially expected 3 .

Recommendations for general surgery activities in a pandemic scenario (SARS-CoV-2)

Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations

Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR