key: cord-337813-r9okti1v
authors: Wiwanitkit, Viroj
title: Delay and Differential Diagnosis and Screening for Symptoms of COVID-19
date: 2020-06-15
journal: J Am Coll Surg
DOI: 10.1016/j.jamcollsurg.2020.05.014
sha: 
doc_id: 337813
cord_uid: r9okti1v

nan

Viroj Wiwanitkit, MD Pune, India

The letter "Beware of Time Delay and Differential Diagnosis when Screening for Symptoms of COVID-19 in Surgical Cancer Patients" by Ghannam and Souadka 1 is very interesting. The authors conclude that "in low-risk COVID-19 urgent surgical procedures with an initial negative symptom screen, we recommend carrying out a new symptom screening before each patient movement." I agree with this suggestion. The patient might be asymptomatic and undergo an operation. The risk of disease transmission to medical personnel is possible. In Indochina, the case report of disease occurrence after operation is a good example. 2 Therefore, there is no doubt that preoperative screening is useful in the current COVID-2019 pandemic. However, the important consideration is what the good screening is. Symptomatic screening seems to be a poor screening tool because many patients can have no symptoms and transmit disease to medical personnel. The routine polymerase chain reaction test might be necessary. Finally, the cost-effectiveness analysis of the screening test implementation is an interesting issue for additional study. The high cost of the polymerase chain reaction test might limit the use in some poor, developing countries. The most important consideration is the universal precautions practice for any patient undergoing an operation regardless of screening result.

Beware of time delay and differential diagnosis when screening for symptoms of COVID-19 in surgical cancer patients

Carpal fracture and COVID-19 infection: observation from Thailand

2020 by the American College of Surgeons