Absence of SARS-CoV-2 RNA in peritoneal fluid during surgery in COVID-19 positive pregnant women

Jakimiuk, Artur J.; Januszewski, Marcin; Santor-Zaczynska, Malgorzata; Jakimiuk, Alicja A.; Oleksik, Tomasz; Pokulniewicz, Marek; Wierzba, Waldemar

Study Objective: COVID-19 infection poses significant risks during surgical interventions. We investigated the intraperitoneal presence of SARS-CoV-2 in COVID-19 positive patients. Design: A prospective group study. Setting: Department of Obstetrics and Gynecology designated for COVID-19 patients, Central Clinical Hospital of the Ministry of Interior, Warsaw Patients: Overall, 65 pregnant women with COVID-19 infection underwent caesarian section. The diagnosis was confirmed either by positive antigen test or by positive RT-PCR assay performed within no more than 13 days prior to the operation. Interventions: On the day of the operation, a nasopharyngeal swab was taken, and peritoneal fluid was collected at the beginning of the operation. Both the nasopharyngeal swab and peritoneal fluid samples were tested for SARS-CoV-2. Measurements and Main Results: A total of 65 pregnant women with COVID-19 infection were enrolled in the study. The SARS-CoV-2 RNA test by nasopharyngeal swab produced positive results in 34 patients. In this group as well as in 31 non-confirmed patients all peritoneal fluid samples tested negative for SARS-CoV-2 RNA. Conclusion: These results suggest a low risk of COVID-19 transmission from the peritoneal cavity at the time of laparoscopy or laparotomy