Anesthetic management and postoperative outcome of pediatric patients with Grade 3 pancreatic trauma injury and asymptomatic COVID-19

Abstract

The global pandemic of coronavirus disease 2019 (COVID-19) has inevitably affected pediatric surgical services. Clinical manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in pediatrics are generally asymptomatic to mild, so they are often not detected during initial screening. In adult population, the postoperative mortality of patients infected with SARS-CoV-2 is 23.8%. The possibility of SARS-CoV-2 transmission to health workers during surgery, the increasing postoperative mortality, and the risk of postoperative complications pose challenges for anesthetists in treating pediatric patients with COVID-19 undergoing emergency surgery. Here, we describe the management of anesthesia and postoperative evaluation of a pediatric patient with asymptomatic COVID-19 who underwent emergency laparotomy due to grade 3 traumatic pancreatic injury under general anesthesia. We found no worsening of clinical symptoms or complications related to COVID-19 on 30 days after surgery. The increase in inflammatory markers was not related to COVID-19 but was an inflammatory response to traumatic injury and surgery.

Keywords

• coronavirus disease-2019
• emergency surgery
• pediatric
• postoperative outcome
• severe acute respiratory syndrome coronavirus-2