잠시만 기다려 주세요. 로딩중입니다.

Coronavirus Disease 2019 Transmission: Blood Viremia and Aerosol Generation from Spinal Surgery. Is There an Increased Risk to the Surgical Team?

Asian Spine Journal 2020년 14권 5호 p.702 ~ 709
Shah Siddharth M., Gadiya Akshay, Patel Mohammed Shakil, Shafafy Masood,
소속 상세정보
 ( Shah Siddharth M. ) - Nottingham University Hospitals NHS Trust Queens Medical Centre Centre for Spinal Studies and Surgery
 ( Gadiya Akshay ) - Nottingham University Hospitals NHS Trust Queens Medical Centre Centre for Spinal Studies and Surgery
 ( Patel Mohammed Shakil ) - Nottingham University Hospitals NHS Trust Queens Medical Centre Centre for Spinal Studies and Surgery
 ( Shafafy Masood ) - Nottingham University Hospitals NHS Trust Queens Medical Centre Centre for Spinal Studies and Surgery

Abstract


As a respiratory pathogen, the novel coronavirus is commonly associated with aerosol-generating procedures. However, it is currently unclear whether spinal surgical procedures pose an additional risk of viral transmission to the surgical team. We reviewed the available evidence to ascertain the presence of coronavirus disease 2019 (COVID-19) blood viremia and the virus’ blood transmissibility, as well as evidence of blood-aerosol generation and operating room contamination from spinal surgical procedures. There is established evidence of COVID-19 blood viremia, a viral pathogenic cycle via angiotensin-converting enzyme 2 (ACE-2) receptors and similar blood transmission risk data from the SARS (severe acute respiratory syndrome)/MERS (Middle East respiratory syndrome) era. Spinal surgical practices demonstrate significant blood-aerosol generation from the operative wound due to the use of common surgical instruments, such as electrocautery, as well as high-speed and high-impact devices. Based on the evidence, there is an established additional risk of viral transmission faced by surgical teams from blood-aerosols generated from the operative wound of COVID-19- infected patients via the inhalation of virus-laden aerosols and the subsequent initiation of the viral pathogenic cycle through binding with pulmonary ACE-2 receptors. Recognizing this additional risk amidst the ongoing pandemic serves as a caution to front-line surgical personnel to strictly adhere to personal protective equipment usage in operating rooms, to modify surgical techniques to reduce the hazard of surgical aerosol generation and COVID-19 viral exposure, and to consider it as an integral aspect of planning and adapting to the “new normal” operating practices.

키워드

COVID-19; Spinal surgery; Aerosol generation; Blood viremia; Viral transmission

원문 및 링크아웃 정보

 

등재저널 정보