The Invisible Part of The Iceberg in Covid-19 Pandemic: Asymptomatic Cases and Anesthesiologists’ Protective Approaches-Knowledge Levels

Öz

Introduction: According to studies asymptomatic COVID-19 cases are thought to be quite high in the community. Their exact number is unknown. Considering that there are false negative results in PCR tests, it should always be considered that all asymptomatic patients may also be COVID-19 positive. We aimed to evaluate the protective and preventive approaches, knowledge levels and technical facilities of anesthesiologists in the perioperative process, after recognizing the COVID-19 alarm symptoms as much as possible and isolating the suspected cases during the pandemic.
Methods: A survey form was prepared to evaluate the awareness of anesthesiologists about asymptomatic cases, their protective-preventive approaches, knowledge levels and technical facilities. The form was created online, with the aim of reaching more participants. The survey form was sent to the participants via e-mail and WhatsApp. Those who did not fill more than 90% of the survey questions were excluded from the study.
Results: According to our study within 100 participants, 95 participants indicated that they question their patients regarding presence of COVID-19-related symptoms and contact history; 86 participants indicated that they evaluate presence of lymphopenia; 78 participants indicated they evaluate CRP levels; 76 participants indicated that they evaluate chest radiography findings; 75 participants indicated evaluation of D-Dimer levels; 74 participants indicated evaluation of ferritin values and 73 participants indicated evaluation of thorax CT findings for a correlation with COVID-19.
Conclusion: The current tests for SARS-CoV-2 are not sensitive enough to rule out the possibility of asymptomatic carriers entering the operating room. It is important to keep in mind the steps that include detecting the patients with high risk of infection even if their PCR tests are negative. 

Anahtar Kelimeler

• SARS-Cov-2
• asymptomatic
• carrier
• COVID-19
• anesthesia

COVID19 Pandemisinde Buzdağının Bilinmeyen Tarafı: Asemptomatik Vakalar ve Anestezistlerin Koruyucu Yaklaşımları-Bilgi Düzeyleri

Öz

Giriş: Çalışmalara göre, toplumda asemptomatik COVID-19 vakalarının oldukça yaygın olduğu düşünülmektedir. Kesin sayıları bilinmemektedir. PCR testlerinde yanlış negatif sonuçlar olduğu göz önüne alındığında, tüm asemptomatik hastaların da pozitif olabileceği dikkate alınmalıdır. Bu çalışmada, COVID-19 alarm semptomlarını mümkün olduğunca tanıdıktan ve pandemi sırasında şüpheli vakaları izole ettikten sonra, perioperatif süreçte anestezistlerin koruyucu ve önleyici yaklaşımlarını, bilgi seviyelerini ve teknik olanaklarını değerlendirmeyi amaçladık.
Materyal ve Metot: Bu çalışma vaka: COVID-19 pandemisinde anestezistlerin asemptomatik vakalara dair farkındalığını, pandemide koruyucu-önleyici yaklaşımları, bilgi düzeylerini ve teknik olanaklarını değerlendiren anket formu hazırlandı. Anket formu online olarak düzenlenip daha fazla katılımcıya ulaşmak hedeflendi. Anket formunun linki internet ortamında mail aracılığıyla ve WhatsApp üzerinden katılımcılara gönderildi. Anket sorularının %90’dan fazlasını doldurmayanlar çalışma dışı bırakıldı.
Bulgular: Çalışmamız sonucunda 100 katılımcının 95’i (%95) hastalarında COVID-19 ilişkili semptom varlığı ve temas öyküsünü, 86’sı (%86) lenfopeni varlığını, 78’i (%78) CRP düzeylerini, 76’sı (%76) akciğer grafisi bulgularını, 75’i (%75) D-Dimer düzeylerini, 74’ü (%74) ferritin değerlerini ve 73’ü de (%73) toraks BT bulgularını preoperatif dönemde COVID-19 ile ilişki açısından değerlendirmektedir.
Sonuç: SARS-CoV-2 için yapılan mevcut testler, asemptomatik taşıyıcıların ameliyathaneye girme olasılığını dışlayacak kadar hassas değildir. PCR testleri negatif olsa bile, yüksek enfeksiyon riski olan hastaları tespit etmeyi içeren adımları akılda tutmak önemlidir.

Anahtar Kelimeler

• SARS-CoV-2
• asemptomatik
• taşıyıcı
• COVID19
• anestezi

Kaynakça

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