Periton sıvısında SARS-CoV-2’nin varlığı ve bunun klinik açıdan önemi: Bir derleme analizi

Year 2022, Volume: 55 Issue: 1, 49 - 52, 30.04.2022

Recep Erçin Sönmez Feride İrem Şimşek Orhan Alımoglu

https://doi.org/10.20492/aeahtd.827326

Abstract

COVID-19 hastalığı; ateş, zatürre veya ishal gibi farklı bulgularla klinik olarak belirgin hale gelebilir. Semptomların bu çeşitliliği, virüsün vücudun farklı bölgelerinde yerleşme olasılığını akla getirmektedir. Bu yönüyle COVID-19 hastalarına abdominal cerrahi uygulayan cerrahlar için de periton sıvısının incelenmesi büyük önem arz etmektedir. Periton sıvısında yeni korona virüsün (SARS-CoV-2) varlığını spesifik olarak araştıran çalışmaları ortaya koymak için COVID-19 pandemisinin ilk başladığı tarihten (Aralık 2019, Wuhan, Çin) Eylül 2020'ye kadar geçen süreyi kapsayan ilgili literatürü gözden geçirmeyi amaçladık. Beş adet tek hastalık vaka sunumları, bir vaka serisi ve bir de devam eden klinik araştırma olmak üzere toplamda yedi adet çalışma belirlendi. Bu çalışmalarda sunulan tüm hastalar, farklı sebeplere sekonder gelişen akut karın kliniği sebebiyle ameliyat edilmiştir. Vaka sunumlarından perioperatif olarak alınan periton sıvılarının RT-PCR (Ters transkriptaz-polimeraz zincir reaksiyonu) analizinde, dört hastada SARS-CoV-2 pozitif saptanmıştır. Bugüne kadar SARS-CoV-2'nin periton sıvısında varlığını dokümente eden çalışmalar sadece birkaç vaka serisi düzeyindedir. Dolayısıyla bu iddiayı bilimsel kanıtlara dayalı olarak güçlendirmek ve cerrahi uygulamada bunun önemini netleştirmek için daha fazla klinik araştırmaya ihtiyaç vardır.

Keywords

COVID-19, SARS-CoV-2, periton sıvısı

Presence of SARS-CoV-2 in peritoneal fluid and its significance in clinical course: A review analysis

Abstract

COVID-19 disease may become clinically apparent with some of the feautures such as fever, pneumonia or diarrhea. This diversity of symptoms brings up to mind the possibility of its presence in different parts of the body. On this aspect, examination of peritoneal fluid draws particular attention for surgeons who perform abdominal surgery for COVID-19 patients. We aimed to review literature beginning from its first outbreak (December 2019, Wuhan, China) till september 2020 to put forward relevant data spesifically investigating the presence of novel corona virus (SARS-CoV-2) in peritoneal fluid. Seven relevant articles were identified of which five of them were single-patient case reports, one report of case series, and one ongoing clinical trial. All patients presented in those studies were undertaken surgeries due to different emergent abdominal conditions. RT-PCR (Reverse transcriptase-polymerase chain reaction) analysis of peritoneal fluids were found positive for SARS-CoV-2 considering four of the case reports. The documentation of SARS-CoV-2 in peritoneal fluid spesifically is based upon few case series. Thus, further clinical researches are needed to strengthen this claim based on scientific evidences, and also to clarify the significance of this if any in era of surgical practice.

Keywords

COVID-19, SARS-CoV-2, peritoneal fluid

References

• 1. Zhu N, Zhang D, Wang W, et al. China Novel Coronavirus Investigating and Research Team. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382:727-33.
• 2. Chadi SA, Guidolin K, Caycedo-Marulanda A, et al. Current Evidence for Minimally Invasive Surgery During the COVID-19 Pandemic and Risk Mitigation Strategies: A Narrative Review. Ann Surg 2020:10.1097/SLA.0000000000004010.
• 3. Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020;109:102433.
• 4. Ngaserin SH, Koh FH, Ong BC, Chew MH. COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient. Langenbecks Arch Surg 2020;405:353-5.
• 5. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in Different Types of Clinical Specimens. JAMA 2020;323:1843-4.
• 6. Wölfel R, Corman VM, Guggemos W, et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020;581:465-9.
• 7. Flemming S, Hankir M, Hering I, et al. Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19. Br J Surg 2020;107:e259-e260.
• 8. SAGES - Society of American Gastrointestinal and Endoscopic Surgeons Recommendations Surgical Response to COVID 19. 2020.
• 9. El Boghdady M, Ewalds-Kvist BM. Laparoscopic Surgery and the debate on its safety during COVID-19 pandemic: A systematic review of recommendations [published online ahead of print, 2020 Aug 11]. Surgeon 2020;S1479-666X(20)30104-9.
• 10. Vigneswaran Y, Prachand VN, Posner MC, et al. What Is the Appropriate Use of Laparoscopy over Open Procedures in the Current COVID-19 Climate? J Gastrointest Surg 2020;24:1686-91.
• 11. Gok AFK, Eryılmaz M, Ozmen MM, et al. Recommendations for Trauma and Emergency General Surgery Practice During COVID-19 Pandemic. Ulus Travma Acil Cerrahi Derg 2020;26:335-42.
• 12. Seeliger B, Philouze G, Benotmane I, et al. Is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present intraperitoneally in patients with coronavirus disease 2019 (COVID-19) infection undergoing emergency operations?. Surgery 2020;168:220-1.
• 13. Coccolini F, Tartaglia D, Puglisi A, et al. SARS-CoV-2 Is Present in Peritoneal Fluid in COVID-19 Patients. Ann Surg 2020;272:e240–2.
• 14. Rimini E, Atzori G, Viotti A. COVID-19 in the peritoneal fluid: does this evidence oblige to introduce new rules? Presentation of a Case Report.Preprint.2020.
• 15. Barberis A, Rutigliani M, Belli F, et al. SARS‐Cov‐2 in peritoneal fluid: an important finding in the Covid‐19 pandemic. Br J Surg 2020; 10.1002/bjs.11816 [Epub ahead of print].
• 16. Chinese Society of Colorectal Surgery, Chinese Society of Surgery, Chinese Medical Association, Colorectal and Anal Surgery Committee, Chinese Research Hospitals Association Chinese expert consensus on surgical diagnosis and treatment strategies for colorectal cancer patients during novel coronavirus peneumonia epidemic. Chin J Pract Surg 2020;40:241-4.
• 17. Assessment of the Presence of the SARS-COV-2 Virus in the Peritoneum of COVID-19 Patients (LAPTRANSCOV). ClinicalTrials.gov Identifier: NCT04361396. Accessed 17 July 2020. https://clinicaltrials.gov/ct2/show/NCT04361396.
• 18. Zheng MH, Boni L, Fingerhut A. Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy. Ann Surg 2020;272:e5-e6.
• 19. Khan MF, Dalli J, Cahill RA. Gas Aerosol Jetstreams from Trocars during Laparoscopic Surgery- A Video Vignette. Colorectal Dis. 2020;10.
• 20. Mintz Y, Arezzo A, Boni L, et al. The risk of COVID-19 transmission by laparoscopic smoke may be lower than for laparotomy: a narrative review. Surg Endosc 2020;34:3298-305.
• 21. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat Rev Microbiol 2009;7:439–50.
• 22. Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19: a systematic review and metaanalysis. Lancet Gastroenterol Hepatol 2020;5:667–78.
• 23. Lan J, Ge J, Yu J, et al. Structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor. Nature 2020;581:215–20.