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.