Persistence of SARS-CoV-2 in Gastric and Gallbladder Tissues Post-COVID-19 in Bariatric Surgery Patients
Overview
This prospective study investigated the presence of SARS-CoV-2 nucleocapsid proteins in gastric and gallbladder tissues of patients with prior COVID-19 infection undergoing laparoscopic sleeve gastrectomy. Despite negative PCR tests preoperatively, viral antigens were detected in tissue specimens, highlighting potential viral persistence in the gastrointestinal tract.
Background
COVID-19 has been extensively studied regarding its epidemiology, transmission, and clinical outcomes. The gastrointestinal tract is a known site of SARS-CoV-2 infection, which may explain gastrointestinal symptoms and prolonged viral shedding in feces. Understanding viral persistence in gastrointestinal tissues is critical for assessing the safety of bariatric surgeries, especially considering potential viral aerosolization during laparoscopic procedures.
Data Highlights
The study enrolled 80 patients with a history of COVID-19 and negative PCR at surgery time. Gastric and gallbladder specimens were collected during laparoscopic sleeve gastrectomy and analyzed using immunohistochemistry for SARS-CoV-2 nucleocapsid proteins. Quantitative serology for SARS-CoV-2 antibodies was performed. Surgical outcomes were monitored over 30 days using the Clavien-Dindo classification.
Key Findings
SARS-CoV-2 nucleocapsid proteins were detected in gastric and gallbladder tissues of patients despite negative PCR tests preoperatively.
Patients had a history of COVID-19 with gastrointestinal symptoms prior to surgery.
Quantitative serology showed strong antibody responses against SARS-CoV-2 spike protein receptor-binding domain.
No significant adverse surgical outcomes related to viral persistence were reported within 30 days postoperatively.
Clinical Implications
The detection of SARS-CoV-2 antigens in gastrointestinal tissues despite negative PCR tests suggests viral persistence beyond the acute infection phase. This finding underscores the importance of strict intraoperative precautions during bariatric surgeries to mitigate potential viral exposure from tissue aerosolization. Clinicians should remain vigilant about gastrointestinal viral reservoirs when planning surgical interventions in post-COVID-19 patients.
Conclusion
SARS-CoV-2 can persist in gastric and gallbladder tissues of patients with prior COVID-19 infection undergoing bariatric surgery, even after negative PCR testing. These findings highlight the need for continued research on viral persistence and its implications for surgical safety.
References
Madina Women’s Hospital Study 2021-2022 -- Persistence of SARS-CoV-2 in Gastric and Gallbladder Tissues
