Comment on: Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19

Editor

We read the contribution by Flemming et al¹. Detection of SARS-CoV-2 on human specimens^2,3 played a considerable role in the comprehension of viral diffusion paths. Since the pandemic beginning, concerns has been raised about risks for surgical staff. Recently SARS-CoV-2 has been detected in peritoneal fluids⁴, bringing new evidence of potential ubiquitarian, transitory presence of viral load in every tissue and fluid. Furthermore, viral presence in human feces after conversion of pharyngeal samples from positive to negative⁵ has already been described just after the beginning of the epidemic. Following the different results obtained by Flemming¹, we could logically confirm the SARS-CoV-2 infection as a complex entity with various behaviors towards human tissues and with a strong tendency to time-dependent changes, but we cannot accept it as an indication allowing to lower our guard. Even considering the stringent necessity to normalize surgical practice, special attention must be given to the protection of healthcare workers. Surgical staffs and some ultra-specialistic branches provide a unique service that cannot be performed by others. Therefore, all of them must be secured, minimizing infections risks, because critically ill and injured patients will continue to need emergent care. Any irresponsible statement that could expose surgical staffs to a higher death risk is not acceptable. Despite the research effort and the undeniable improving of SARS-CoV-2 knowledge, we still do not control completely the pathophysiology and the epidemiology of the infection. Precise understanding of different patterns of infection manifestation and progression (especially in non-conventional non-respiratory syndromes) is mandatory before giving improvident advices. This will let us ready for a possible future fresh outbreak. The more we learn about actual experience, the less we will suffer in the upcoming future. Actual experience showed we still have to understand the concept of “learning from previous mistakes”.