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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Thorac+Cardiovasc+Surg
2020 ; 160
(2
): 585-592.e2
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Clinical course of coronavirus disease 2019 in 11 patients after thoracic surgery
and challenges in diagnosis
#MMPMID32414594
Peng S
; Huang L
; Zhao B
; Zhou S
; Braithwaite I
; Zhang N
; Fu X
J Thorac Cardiovasc Surg
2020[Aug]; 160
(2
): 585-592.e2
PMID32414594
show ga
OBJECTIVES: To illustrate the clinical course and difficulties in early diagnosis
of coronavirus disease 2019 (COVID-19) in patients after thoracic surgery.
METHODS: We retrospectively analyzed the clinical course of the first 11 patients
diagnosed with COVID-19 after thoracic surgery in early January 2020.
Postoperative clinical, laboratory, and radiologic records and the time line of
clinical course were summarized. Potential prognostic factors were evaluated.
RESULTS: In the 11 confirmed cases (3 female, 8 male), median days from symptom
onset to case detection was 8. Insidious symptom onset and misinterpreted
postoperative changes on chest computed tomography (CT) resulted in delay in
diagnosis. There were 3 fatalities due to respiratory failure, whereas 4 severe
and 4 mild cases recovered and were discharged. All patients had once experienced
leukocytosis and eosinopenia. Remittent fever and resected lung segments ?5 were
associated with fatality. CONCLUSIONS: The case fatality rate of postsurgical
patients subsequently diagnosed with COVID-19 was 27.3%. Insidious symptom onset,
postoperative leukocytosis with lymphopenia, and postsurgical CT changes
overshadowed the early signs of viral pneumonia. Dynamic symptom monitoring,
serial chest CTs, and tests for viral RNA and serum antibody improve the chance
for prompt detection of COVID-19. Consideration should be given to preadmission
and preoperative screening and strict contact isolation during the postoperative
period.