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

Öz

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.

Anahtar Kelimeler

• COVID-19
• SARS-CoV-2
• periton sıvısı

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

Öz

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.

Anahtar Kelimeler

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

Kaynakça

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