key: cord-0858293-a665ndw0
authors: Chow, Tam‐Lin; Fung, Kitty S. C.; Chan, Yiu‐Cheung
title: COVID‐19 masquerading emergency surgical problems: Lessons learnt from four cases diagnosed in the surgical ward
date: 2021-03-31
journal: Surg Pract
DOI: 10.1111/1744-1633.12494
sha: d0e1b66d4305dd3ab64092ddae1b93d11935ac1c
doc_id: 858293
cord_uid: a665ndw0

nan

From our recent observation, the symptoms of patients with COVID are deceptive and can well mimic those of acute surgical problems. We encountered, within a month, four COVID cases confirmed in surgical wards with initial diagnoses of emergency surgical problems. We will share herein some lessons learnt by reviewing these four cases to alert other healthcare workers. A systematic literature review was attempted to elucidate this facet in a wider perspective. If resources and facilities are available, screening at AED is highly recommended before admission. Alternatively, admission to the dedicated COVID surveillance ward is a viable solution. It is also advisable to place newly admitted emergency patients in designated cubicle or isolation room if practically possible within the general surgical ward amid the COVID-19 pandemic. Liberal SARS-CoV-2 testing is also valuable to identify such hidden cases.

Meal gathering of ward staff should be discouraged. Utilisation of recommended PPE with appropriate masks, eye goggles or face shields, and protective garments during high-risk ward procedures [eg, CPAP (case 1)], collection of samples for COVID tests, or feeding patients will be necessary. Without doubt, low threshold of suspicion for patients with symptoms of COVID with a history of close contact with confirmed cases or subtle CXR haziness is of utmost importance to minimise spreading of infection in surgical wards. This is well illustrated by case 3 in which no close or ordinary contact was recognised on tracing.

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There is no financial support or conflict of interest to be declared.