Objectives
The exposure risks to front-line health care workers (HCWs) who are in close proximity for prolonged periods of time, caring for COVID-19 patients undergoing surgery or obstetrical delivery, is unclear. Understanding of sample types that may harbour virus is important for evaluating risk. The objectives are as follows: to determine if SARS-CoV-2 viral RNA from patients with COVID-19 undergoing surgery or obstetrical delivery is present in: 1) the peritoneal cavity of males and females 2) the female reproductive tract, 3) the environment of the surgery or delivery suite (surgical instruments, equipment used, air or floors) and 4) inside the masks of the attending health care workers.
Methods
In this cross-sectional study, conducted at 2 Toronto hospitals, 32 patients with COVID-19 underwent urgent surgery or obstetrical delivery and the presence of SARS-CoV-2 viral RNA in patient, environmental and air samples was identified by real time reverse transcriptase polymerase chain reaction. Air samples were collected using both active and passive sampling techniques. The primary outcome was the proportion of HCW masks positive for SARS-CoV-2 RNA.
Results
SARS-CoV-2 RNA was detected in 20/332 (6%) patient and environmental samples collected: 4/24 (16.7%) patient, 5/60 (8.3%) floor, 1/5 (1.9%) air, 10/23 (43.5%) surgical instruments/equipment, 0/24 cautery filters and 0/143 (95% CI 0–0.026) inner surface of mask samples.
Conclusions
While there is evidence of SARS-CoV-2 RNA in the surgical and obstetrical operative environment, the finding of no detectable virus inside the masks worn by the medical teams would suggest a low risk of infection for our health care workers using appropriate personal protective equipment.
Keywords
SARS-CoV-2 viral RNA; PPE; exposure risk; health care workers; real time RT-PCR; environmental and air sampling; operating room exposure; delivery room exposure