Elektif Katarakt Ameliyatı Öncesinde Covid-19 RT-PCR Testi Yapılmalı mı? Prevelans ve Maliyet Analizi Işığında Bir Çalışma

Yıl 2021, Cilt: 6 Sayı: 4, 548 - 553, 01.12.2021

Selim Cevher Mehmet Barış Üçer Tayfun Şahin

https://doi.org/10.26453/otjhs.991434

Öz

Amaç: Elektif katarakt ameliyatı planlanan hastalarda asemptomatik Covid-19 seroprevalansını, Covid-19'un katarakt ameliyatına maliyet etkilerini ve tarama testinin ameliyat öncesi rutin olarak kullanılmasının etkilerini tartışmak amaçlanmıştır.

Materyal ve Metot: Bu çalışma kesitsel ve gözlemsel bir çalışmadır. Çalışma grubunu pandemi döneminde ameliyat öncesi SARS CoV 2 için gerçek zamanlı polimeraz zincir reaksiyonu (RT PCR) testi yapılan hiçbir Covid-19 semptomu olmayan 217 hasta kontrol grubunu ise pandemi öncesi daha önce elektif katarakt ameliyatı geçiren 200 hasta oluşturdu. Demografik özellikleri ve hastanede kalış süreleri kaydedildi. Ekipman ücretleri, laboratuvar ücretleri, ilaç ücretleri ve hastane hizmet ücretleri kayıt altına alınarak maliyet analizi yapıldı. Covid-19 seroprevalansı hesaplandı.

Bulgular: Hastanemizde pandemi döneminde elektif katarakt cerrahisi uygulanan tüm hastalarda asemptomatik Covid-19 enfeksiyonu seroprevalansı %1,8 idi. Grupların ortalama maliyeti arasında anlamlı fark vardı (p<0,001).

Sonuç: Asemptomatik hastalarda hastalığın seroprevalansı çok düşük olmasına ve hastalığın ameliyat maliyetini artırmasına rağmen, asemptomatik hastaları belirlemek ve bulaşıcılığı azaltmak için COVID-19 taramasına devam edilmesi gerektiğini düşünüyoruz.  

Anahtar Kelimeler

Covid-19, Katarakt Cerrahisi, Seroprevalans, Tedavi Maliyeti, Ameliyat öncesi testler

Should Covid-19 RT-PCR Test Be Performed Before Elective Cataract Surgery? A study In the Light of Prevalence and Cost Analysis

Öz

Objective: It was aimed to argue the asymptomatic Covid-19 seroprevalence in patients scheduled for elective cataract surgery, to investigate the cost effects of Covid-19 on cataract surgery, and the effects of routinely using the screening test before surgery.

Materials and Methods: This is a cross-sectional and observational study. The study group included 217 patients without any symptoms of Covid-19 who underwent real-time polymerase chain reaction (RT PCR) testing for SARS CoV 2 before surgery during the pandemic period and the control group included 200 patients who underwent elective cataract surgery procedure before the Covid-19 pandemic. Their demographic characteristics and the length of hospital stay were recorded. Equipment fees, laboratory fees, drug fees, and hospital service fees were recorded, and cost analysis was made. Seroprevalence of Covid-19 was calculated.

Results: The seroprevalence of the asymptomatic Covid-19 infection among all elective cataract surgery patients in our hospital was 1.8%. There was a significant difference between the average cost of the groups (p<0.001).

Conclusion: Although the seroprevalence of the disease is very low among asymptomatic patients and the disease increases the cost of the surgery, we think that to identify asymptomatic patients and reduce contagiousness, screening for COVID-19 should continue. 

Anahtar Kelimeler

Covid-19, Cataract Surgery, Seroprevalence, Cost of Treatment, Preoperative testing

Kaynakça

• Horton R. Offline: COVID-19 and the NHS-"a national scandal". Lancet. 2020;395(10229):1022.
• COVIDSurg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. Br J Surg. 2020;107(11):1440-1449.
• American College of Surgeons. Joint Statement: Roadmap for Resuming Elective Surgery after COVID 19 Pandemic 2020. Available from: https://www.facs.org/covid 19/clinical guidance/ roadmap elective surgery. Accessed August 13, 2020.
• Öner F. An Overview of otorhinolaryngology and head and neck surgery practice in COVID-19 pandemic. Anatolian Clinic the Journal of Medical Sciences. 2020;25(Special Issue 1):185-194.
• Sharma B, Abell RG, Arora T, Antony T, Vajpayee RB. Techniques of anterior capsulotomy in cataract surgery. Indian J Ophthalmol. 2019;67(4):450-460.
• Rivett L, Sridhar S, Sparkes D, et al. Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission. Elife. 2020;9:e58728.
• Ji T, Chen HL, Xu J, et al. Lockdown contained the spread of 2019 novel coronavirus disease in Huangshi city, China: early epidemiolo- gical findings. Clin Infect Dis. 2020;71(6):1454-1460
• Clarke C, Prendecki M, Dhutia A, et al. High Prevalence of Asymptomatic COVID-19 Infection in Hemodialysis Patients Detected Using Serologic Screening. J Am Soc Nephrol. 2020;31(9):1969-1975.
• Kim GU, Kim MJ, Ra SH, et al. Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect. 2020;26(7):948.e1-948.e3.
• Dong Y, Mo X, Hu Y, et al. Epidemiology of COVID-19 among children in China. Pediatrics. 2020;145(6):e20200702.
• He J, Guo Y, Mao R, Zhang J. Proportion of asymptomatic coronavirus disease 2019: A systematic review and meta-analysis. J Med Virol. 2021;93(2):820-830.
• Singer JS, Cheng EM, Murad DA, et al. Low prevalence (0.13%) of COVID-19 infection in asymptomatic pre-operative/pre-procedure patients at a large, academic medical center informs approaches to perioperative care. Surgery. 2020;168(6):980-986.
• Kannan NB, Sen S, Reddy H, Kumar K, Rajan RP, Ramasamy K. Preoperative COVID-19 testing for elective vitreoretinal surgeries: Experience from a major tertiary care institute in South India. Indian J Ophthalmol. 2020;68(11):2373-2377.
• Goel R, Arora R, Khanam S, Saxena S, Manchanda V, Pumma P. Is it essential to perform COVID-19 testing prior to ophthalmic procedures?. Indian J Ophthalmol. 2020;68(11):2335-2337.
• Al-Khersan H, Kalavar MA, Tanenbaum R, et al. Emergent Ophthalmic Surgical Care at a Tertiary Referral Center During the COVID-19 Pandemic. Am J Ophthalmol. 2021;222:368-372.
• Kaban I, Bacanakgil BH. COVID-19 RT-PCR Test Results of Preoperative Gynecologic and Obstetric Patients in a Pandemic Hospital in Istanbul. Crescent Journal of Medical and Biological Sciences. 2021;8(2):90-92.
• Nekkanti SS, Vasudevan Nair S, Parmar V, et al. Mandatory preoperative COVID-19 testing for cancer patients-Is it justified? J Surg Oncol. 2020;122(7):1288-1292.
• Kovoor JG, Tivey DR, Williamson P, et al. Screening and testing for COVID-19 before surgery. ANZ J Surg. 2020;90(10):1845-1856.
• Hu Z, Song C, Xu C, et al. Clinical characteristics of 24 asymptomatic infections with COVID-19 screened among close contacts in Nanjing, China. Sci China Life Sci. 2020;63:706–11.
• Wang Y, Liu Y, Liu L, Wang X, Luo N, Li L. Clinical outcomes in 55 patients with Severe acute respiratory syndrome Coronavirus- 2 who were asymptomatic at hospital admission in Shenzhen, China. J Infect Dis. 2020;221:1770–4.
• COVID-19 rapid guideline: arranging planned care in hospitals and diagnostic services. London: National Institute for Health and Care Excellence (UK); 2020 Jul 27. (NICE Guideline, No. 179.). https://www.nice.org.uk/guidance/ng179/resources/covid19-rapid-guideline-arranging-planned-care-in-hospitals-and-diagnostic-services-pdf-66141969613765. Accessed July 27, 2020.
• Mahmood M, Ilyas NU, Khan MF, Hasrat MN, Richwagen N. Transmission frequency of COVID-19 through pre-symptomatic and asymptomatic patients in AJK: a report of 201 cases. Virol J. 2021 Jul 3;18(1):138.