A prospective study to identify rates of SARS-CoV-2 virus in the peritoneum and lower genital tract of patients having surgery: an observational study

Jones, Dominique; Faluyi, David; Hamilton, Sarah; Stylianides, Nicholas; Ma, Ken; Duff, Sarah; Machin, Nicholas; Edmondson, Richard J

STUDY OBJECTIVE: The risks to surgeons of carrying out aerosol generating procedures during the COVID pandemic are unknown. To start to define these risks, in a systematic manner, we investigated the presence of SARS-CoV-2 virus in the abdominal fluid and lower genital tract of patients undergoing surgery. DESIGN: A prospective cross sectional observational study. SETTING: A single large UK Hospital PATIENTS: O 113 patients undergoing abdominal surgery or instrumentation of the lower genital tract. INTERVENTIONS: We took COVID swabs from the peritoneal cavity and from the vagina from all eligible patients. Results were stratified by pre operative COVID status. MEASUREMENTS AND MAIN RESULTS: In patients who were presumed COVID negative at the time of surgery SARS-CoV-2 virus RNA was detected in 0/102 peritoneal samples and 0/98 vaginal samples. Both cohorts included four patients who were antibody positive but nasopharyngeal sab test negative at the time of surgery. Peritoneal and vaginal swabs were also negative in one patient who had a positive nasopharyngeal swab immediately prior to surgery. CONCLUSIONS: The presence of SARS-CoV-2 RNA in the abdominal fluid or lower genital tract of presumed negative patients is nil or extremely low. These data will inform surgeons of the risks of restarting laparoscopic surgery at a time when COVID19 is endemic in the population. BRIEF FUNDING STATEMENT: There was no external funding of this study