key: cord-0740374-6yeumb1k
authors: Bellato, V; Konishi, T; Pellino, G; An, Y; Piciocchi, A; Sensi, B; Siragusa, L; Khanna, K; Pirozzi, B M; Franceschilli, M; Campanelli, M; Efetov, S; Sica, G S; Kefleyesus, A; Hoofwijk, A G M; Eldaly, Abdullah Sami; Gonzalez, Abel; Jawad, Adraoui; Jooma, Ahmad; Hafez, Ahmed Mousa; Rubio, Ainhoa Valle; Landaluce-Olavarria, Aitor; Wu, Aiwen; Nagatsu, Akihisa; Inoue, Akira; Kanamoto, Akira; Ouchi, Akira; El-Hussuna, Alaa; Vazquez-Melero, Alba; Wolthuis, Albert M; Peral, Alberto M; Lozano, Alejandra Cruz; Efremov, Aleksandr; Ryasantsev, Aleksandr V; Di Giorgio, Alessandra; Parente, Alessandro; Tamburrini, Alessandro; Alò, Alessio; Forero-Torres, Alexander; Vahrmeijer, Alexander L; Varabei, Alexander; Hinojosa, Siles; Balkan, Ali Zeynel Abidin; Frontali, Alice; Oleg, Alikin; Soler-Silva, Álvaro; Makni, Amin; André, Ana; Cabrera, Ana María García; Fernández, Ana María Gonzalez; Minaya-Bravo, Ana M; Rodríguez-Sánchez, Ana; Musina, Ana-Maria; Pangeni, Anang; Zolotko, Anastasia; Tonoyan, Andranik; Balla, Andrea; Belli, Andrea; Cavallaro, Andrea; Chierici, Andrea; Divizia, Andrea; Bucci, Andrea Fares; Salido, Andrea Jiménez; Morini, Andrea; Muratore, Andrea; Vignali, Andrea; Chitul, Andrei; Sebastian, Diaconescu Andrei; Pcolkins, Andrejs; Shchegolev, Andrey; Hollenbeck, Andrew; Wisneski, Andrew; Iossa, Angelo; D'Amore, Anna; Hunter, Anndrew; Hesketh, Anthony J; La Brocca, Andrea; Spinelli, Antonino; Caires, Antonio; D'Alessandro, Antonio; Correo, Antonio Francisco Sanchís López; Macrì, Antonio; Navarro-Sánchez, Antonio; Pronk, Apollo; Akunc, Aram; Mehri, Arash; Pelta, Arie; Papadopoulos, Aristeidis; Kechagias, Aristotelis; Rashid, Arshad; Ramazanov, Artur; Chandio, Ashfaq; Kohyama, Atsushi; Nishimura, Atsushi; Ohkawa, Atsushi; Dulskas, Audrius; Jamal, Aun; Mariani, Aurora; Unal, Ayse Gizem; Karagoz, Ayse; Ozkan, Bahar Busra; Salih, Barham; Gülcü, Baris; Pessia, Beatrice; Martin-Perez, Beatriz; Ielpo, Benedetto; Tulelli, Berenice; Yang, Bin; Mhamed, Boumadani; Murphy, Brenda; Pirozzi, Brunella Maria; 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Liscia, Gadiel; Gallo, Gaetano; Asawa, Ganesh; Wang, Gaoxiang; Raiyani, Gaurang; Beets, Geerard; Naval, Gemma Sugrañes; Jin, Genfeng; Chang, George J; Saakian, George; Kahane, Gerardo; Borroni, Giacomo; Lo Secco, Giacomo; Baiocchi, Gian Luca; Baronio, Gianluca; Pagano, Gianluca; Pattacini, Gianmaria Casoni; Lisi, Giorgio; Milito, Giovanni; Sinibaldi, Giovanni; Serrao, Giuditta; Bagaglini, Giulia; Sarro, Giuliano; Brisinda, Giuseppe; Candilio, Giuseppe; Mangiameli, Giuseppe; Giuliani, Giuseppe; Martin-Martin, Gonzalo Pablo; Bodzin, Gordon; Leon, Graat; Mackay, Graham; Vasil, Granila; Palmisano, Graziano; Giovanna, Grella Maria; Fernández, Guadalupe Campos; Steingel, Guillermo Berrones; Zhang, Guoyun; Choi, Gyu Seog; Chen, Haipeng; Hirose, Hajime; Kayano, Hajime; Ulgur, Hanife Seyda; Impellizzeri, Harmony; Ariola, Hasani; Liu, Heli; Medina, Heriberto; Miyauchi, Hideaki; Takahashi, Hidekazu; Hayashi, Hideki; Ishikawa, Hideki; Ishida, Hideyuki; De Vries, Hilbert; Ulman, Hilmican; Kon, Hirofumi; Ota, Hirofumi; Akamatsu, Hiroki; Tamagawa, Hiroshi; Shoji, Hirotaka; Egi, Hiroyuki; Matsubara, Hisahiro; Miki, Hisanori; Elfeki, Hossam; Lin, Hung-Hsin; Giani, Iacopo; Caravaca-García, Iban; Takemasa, Ichiro; Angriman, Imerio; Negoi, Ionut; Volkova, Irina; Russo, Iris; Kronberger, Irmgard E; Shageev, Iskander; Aydin, Ishak; Mora Guzmán, Ismael; Novak, Ivana; Giuliano, Izzo; Rachmuth, Jacob; Ngu, James Chi-Yong; Glasbey, James; Stoot, Jan; Žatecky, Jan; Melenhorst, Jarno; Van Der Wal, J B C; Leijtens, Jeroen; Bogach, Jessica; Elliott, Jessie; De Wilt, J H W; Han, Jiagang; Cui, Jian; Liu, Jiaqi; Khan, Jim; Wirawan, Jimmy Panji; Zhang, Jinji; Manyari, Joel Davis Osorio; Doerner, Johannes; Bock, Jonathan; Konsten, Joop; Castro, Jorge Mario; Grobas, Jorge Pérez; Pereira, José; Juloski, Jovan; Laina, Juan Luis Blas; Solórzano, Juan José; López, Juan Ramón Gómez; Li, Jun; Watanabe, Jun; Kwak, Jung-Myun; Hasegawa, Junichi; Hiro, Junichiro; Sergey, K; Zhang, Kai; Nagahori, Kaoru; Martinez, Karla; Tokuhara, Katsuji; Danno, Katsuki; Uehara, Kay; Yoshimatsu, Kazuhiko; Ehara, Kazuhisa; Ueda, Kazuki; Suda, Kazuyoshi; Yamamoto, Kazuyuki; Ishimaru, Kei; Kimura, Kei; Hirata, Keiji; Deen, Kemal; Imaizumi, Ken; Yamada, Jenji; Tanakura, Kenta; Rida, Khaled; Sugimoto, Kiichi; Kotaro, Kitani; Shi, Kiwisure; Okabayashi, Koji; Hida, Koya; Kataoka, Kozo; Hongo, Kumiko; Xia, Kunkun; Tseng, Larissa; Reime, Lars; Lorenzon, Laura; Ruano, Laura Muiños; Siragusa, Leandro; Zhou, Lei; De Nes, Lindsey; Brandariz, Lorena; Morini, Lorenzo; Petagna, Lorenzo; Ripamonti, Lorenzo; Martinez, Lourdes Hernandez; Pio, Luca; Sacco, Luca; Carvalho, Lucia; Zorcolo, Luigi; Pérez-Sánchez, Luis Eduardo; Esparza, Luis Humberto Reyes; Aguilar, Luis Tallon; Garner, Madeleine; Sugimoto, Maki; Nagashima, Makoto; Shiozawa, Manabu; Simone, Manfredelli; Ferrer-Marquez, Manuel; Carvalho, Marcia; Alifano, Marco; Arganini, Marco; Calussi, Marco; Catarci, Marco; Allaix, Marco Ettore; Forlin, Marco; Milone, Marco; Paci, Marco; Franceschilli, Marzia; 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title: Impact of asymptomatic COVID-19 patients in global surgical practice during the COVID-19 pandemic
date: 2020-08-06
journal: Br J Surg
DOI: 10.1002/bjs.11800
sha: 56222febaeaab6e5fdf7dc9313c5225765219914
doc_id: 740374
cord_uid: 6yeumb1k

nan

per cent of the centers, and the proportion was less than 30 per cent even in severely affected countries. Asymptomatic COVID-19 patients who tested positive postoperatively were reported from 27⋅5 per cent of the centres, with higher rates in higher risk countries (high risk, 51⋅5 per cent; intermediate risk, 27⋅3 per cent; low risk, 5⋅8 per cent; p < 0⋅001). To further clarify the clinical impact of asymptomatic COVID-19 patients, the second survey was sent to 218 centres that experienced such patients and had contact information, and 149 responded. The median number of asymptomatic COVID-19 patients testing positive after surgery per centre was 2 (range, 1 to 20). After experiencing the first asymptomatic COVID-19 patients, most centers (81⋅9 per cent) changed testing policies and/or preventive measures in surgical practice. Worse surgical outcomes in asymptomatic COVID-19 patients were reported from 30⋅9 per cent of the centres.

To our knowledge, this is one of the largest international surveys on COVID-19 in the field of surgery. Acknowledging the biases caused by unintended selection of centres, unequal number of centres per country and uneven geographical coverage, this large survey captured the global surgical practice under the COVID-19 pandemic and highlighted the threat of asymptomatic patients. Asymptomatic COVID-19 patients who were tested positive postoperatively may represent insufficient preoperative screening in the current surgical practice. The clinical impact of asymptomatic COVID-19 patients for surgeons is evident by the fact that the detection of such asymptomatic patients resulted in the change of testing policies and/or preventive measures in most of the centres. We strongly believe that in the coming phase of pandemic, during which many medical centres will resume elective surgeries, a call for action in surgical departments for more intensive screening programs is needed in global plans.

The study was registered with an analysis plan on ClinicalTrials.gov (NCT04344197)

We would like to thank all the collaborators of "S-COVID Collaborative 

Additional supporting information can be found online in the Supporting Information section at the end of the article.