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Intraoperative Diagnosis of Coronavirus Disease 2019 in an Asymptomatic Patient: A Case Report
Andrew K Davis-Sandfoss1, BobbieJean Sweitzer
1From the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Insights
Asymptomatic patients with coronavirus disease 2019 (COVID-19) pose a significant transmission risk in perioperative settings. Intraoperative diagnosis in an asymptomatic patient highlights the need for high clinical suspicion during surgical care.
Area of Science:
- Anesthesiology
- Infectious Diseases
- Critical Care Medicine
Background:
- The perioperative setting presents unique challenges for managing patients with coronavirus disease 2019 (COVID-19).
- Asymptomatic COVID-19 patients, undiagnosed preoperatively, represent a substantial risk for nosocomial transmission.
- Limited healthcare resources often prioritize diagnostic testing for symptomatic or exposed individuals.
Observation:
- This case report details the intraoperative diagnosis of COVID-19 in a patient presenting without symptoms or known exposure.
- Clinical signs observed during surgery prompted diagnostic testing, leading to the identification of COVID-19.
- The diagnosis was confirmed while the patient was undergoing a surgical procedure.
Findings:
- An intraoperative diagnosis of COVID-19 was made in an asymptomatic patient.
- Clinical vigilance and a high index of suspicion were crucial for identifying the infection.
- The patient's asymptomatic status at presentation masked the underlying COVID-19 infection.
Implications:
- A high index of suspicion is essential for perioperative care, even in asymptomatic patients.
- Early identification of asymptomatic COVID-19 cases can mitigate intraoperative and postoperative transmission risks.
- This underscores the importance of considering COVID-19 in differential diagnoses for perioperative patients exhibiting subtle clinical changes.
Abstract:
Patients with coronavirus disease 2019 (COVID-19) with variable clinical presentations are encountered in the perioperative setting. While some have already been diagnosed and are symptomatic, others have undiagnosed, asymptomatic COVID-19. The latter group poses the greatest risk of transmission. Given limited capacities in most health care systems, diagnostic testing is mainly performed in symptomatic patients or those with relevant exposure. We report an intraoperative diagnosis of COVID-19 in an asymptomatic patient, prompted by clinical signs. To control a pandemic such as COVID-19, a high index of suspicion is pivotal when caring for asymptomatic patients in the perioperative setting.
