Postoperative fever in the time of COVID-19

Postoperative fever in the time of COVID-19

Can J Surg 2020;63(3):E231-E232 | PDF

Jonathan Bourget-Murray,* MD CM; Bryan J Heard,* MD, PhD; Rohit Bansal, MBBS, MS (Ortho), D.(Ortho); Andrew S Johnson, MD; James Powell, MD

Summary

Postoperative fever is common following orthopedic trauma surgery. As the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases in the community, migration into the acute care hospital setting intensifies, creating confusion when fever develops postoperatively. The transmission dynamics of SARS-CoV-2 make it difficult to adequately gauge and pinpoint risk groups with questionnaires at the time of hospital admission. This is particularly problematic when asymptomatic or presymptomatic patients infected with SARS-CoV-2 require urgent surgery and cannot be screened effectively. One approach is to treat every patient as though they were SARS-CoV-2-positive in preparation for surgery, but doing so could exacerbate shortages of personal protective equipment and staffing limitations. Uncertainty regarding the etiology of postoperative fever could be significantly reduced by universal SARS-CoV-2 testing of all surgical patients at the time of hospital admission in addition to routine screening, but testing capacity and a rapid turnaround time would be required.


*Share first authorship.

Accepted May 4, 2020

Affiliations: From the Department of Surgery, Division of Orthopaedic Surgery, University of Calgary, Calgary Alta. (Bourget-Murray, Bansal, Heard, Powell); and the Department of Medicine, Division of Infectious Diseases, University of Calgary, Calgary, Alta. (Johnson).

Competing interests: None declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.004720

Correspondence to: J. Powell, Department of Surgery, Division of Orthopaedic Surgery, University of Calgary, McCaig Institute for Bone and Joint Health, 3330 Hospital Drive NW, Calgary AB T2N 4N1, jnpowellemail@yahoo.ca