Patient population
PANDEMIC-Group . A total of 24 patients fulfilled the inclusion criteria of the present study. The clinical and epidemiological data are summarized in Table 1. There were 15 men (62.5%) and 9 women (37.5%) with a male to female ratio of 1.7:1. The ages ranged from 12 to 89 years (mean, 59 ± 20 years). The first sixteen patients (66,7%) were not tested for COVID-19 since they didn’t report any Sars-CoV-2 related symptoms or temperature increase at the time of admission. The next eight patients (33,3%) were all tested for COVID-19 and only one male patient (4,2%) resulted positive at the time of hospital admission. This patient was affected by squamous cell carcinoma arising in inverted papilloma and was scheduled for surgery on March 13th. He underwent swab collection as he had complained of diarrhea 3 days before. After being found positive for SARS-Cov-2, the patient was transferred to a COVID-19 specific area, until three consecutive nasopharyngeal swabs, performed 24 hours apart from each other, tested negative. Notwithstanding the negative results of the swabs, the patient was prudentially operated in the COVID-19 Operating Room, with highest-standard PPE as indicated by the above mentioned recommendations.[5] Among the 24 cases operated, only one complication (4.2%) occurred. A female patient affected by recurrent skull base chondrosarcoma after multiple endoscopic resections and irradiations, ended two years earlier, underwent endoscopic endonasal debulking of the recurrence of disease and developed a temporal lobe abscess, diagnosed on 11th postoperative day after hospital discharge. The patient was readmitted to the hospital for neurosurgical intervention of stereotactic aspiration and drainage of brain abscesses and her SARS-Cov-2 swab collection performed upon readmission on April 7th was negative. The culture tests were compatible with S. marcescens infection and the patient was discharged after 15 days of intravenous targeted antibiotic therapy, with MRI confirmation of resolution of the abscess. At last follow-up, the patient was asymptomatic, she hasn’t developed symptoms compatible with COVID-19 and she is going to start adjuvant treatments as soon as possible.
The follow-up period for the 24 patients ranges from 14 to 71 days (mean 50 days). During the postoperative follow-up, updated to May 5th, 20 patients (83.3%) didn’t refer any symptom. Two patients (8.3%) referred headache and two patients (8.3%) complained diarrhea, in all cases with onset of symptoms occurring after April 25th. The two patients complaining diarrhea performed nasopharyngeal swab, which tested negative in both of the cases. No patients were hospitalized nor developed COVID-19 respiratory manifestations.
CONTROL-Group. In the same period in 2019, 61 operated patients met the inclusion criteria. There were 29 men and 32 women, with a male to female ratio of 0.9:1. The ages ranged from 11 to 88 years. The distribution of the cases according to the pathology treated is provided in Table 2.