Clinical Scorecard: Guidelines for Surgical Procedures and Patient Care During the COVID-19 Pandemic
At a Glance
Category
Detail
Condition
COVID-19 caused by SARS-CoV-2 infection
Key Mechanisms
SARS-CoV-2 binds ACE2 receptors on host cells, facilitating viral entry and infection; ACE2 is expressed in cardiopulmonary and gastrointestinal epithelial cells
Target Population
Patients requiring surgical care during the COVID-19 pandemic, including SARS-CoV-2 positive and negative individuals
Care Setting
Hospital surgical departments, including emergency rooms, operating areas, and non-intensive care wards
Key Highlights
Surgical care must be prioritized with postponement of elective procedures and continuation of emergency and urgent surgeries.
Separate pathways and wards for SARS-CoV-2 positive and negative patients should be established to prevent cross-infection.
Interdisciplinary daily assessment is essential to adapt surgical care protocols dynamically during the pandemic.
Guideline-Based Recommendations
Diagnosis
Recognize that SARS-CoV-2 infection may present with non-specific or oligosymptomatic signs, complicating identification in surgical patients.
Implement screening protocols to identify SARS-CoV-2 positive patients prior to surgery.
Management
Postpone or suspend non-urgent elective surgeries as mandated by health authorities.
Continue emergency surgical care and operative therapy for tumor patients and urgent indications.
Create a prioritization list of surgical interventions based on medical urgency and logistical considerations.
Establish SARS-CoV-2 and non-SARS-CoV-2 emergency rooms and surgical wards.
Designate specific operating areas for SARS-CoV-2 positive patients.
Monitoring & Follow-up
Conduct daily interdisciplinary team assessments including anesthesiology, intensive care, internal medicine, surgery, infectiology, and hospital hygiene to adapt protocols.
Monitor resource availability such as ICU capacity, personnel, and protective equipment.
Risks
Risk of SARS-CoV-2 transmission to healthcare workers and other patients during surgical procedures.
Potential worsening of patient outcomes if urgent surgeries are delayed.
Challenges in identifying asymptomatic or oligosymptomatic SARS-CoV-2 positive surgical patients.
Patient & Prescribing Data
Surgical patients during the COVID-19 pandemic, including those with confirmed or suspected SARS-CoV-2 infection
Surgical treatment decisions must balance urgency of intervention against infection risk and resource constraints; telemedicine may be used for outpatient management and prioritization.
Clinical Best Practices
Develop and maintain a prioritized surgical intervention list with defined urgency levels.
Coordinate closely among surgical, anesthesiology, intensive care, microbiology, virology, and hospital hygiene teams.
Implement separate clinical pathways and wards for SARS-CoV-2 positive and negative patients.
Use protective equipment and infection control measures rigorously during surgical procedures.
Adapt surgical care protocols dynamically based on daily interdisciplinary evaluations.
