Post-operative management and issues
Post-operative period was even more complex. In one older patient affected by chronic pulmonary disease, we observed on the fourth day after surgery the onset of fever, dyspnea and desaturation during wide-spectrum antibiotic therapy; for this reason, he underwent chest-TC, which showed sign of interstitial involvement by an inflammatory process. The infectious disease specialist, was then asked to evaluate the patient and decided to move him from our inpatient clinic to a ward dedicated to COVID-19 positive patients, waiting for the result of NP and OP swabs. All the swabs resulted negative for infection and were repeated after 24h for a confirmation. However, the patient remained in the COVID-19 unit until the resolution of pulmonary infection, thus prolonging his overall hospital stay. In another case, we had a delay in the scheduled operatory session, due to the presence of suspect radiologic findings in an asymptomatic patient with ground-glass opacities and interstitial inflammation, emerged with a staging chest-CT and not evident at the routine pre-admission chest-RX. In a dialysis patient, the onset of fever and dyspnea on the second postoperative day required a new COVID-19 test; due to the waiting of the result (about 24 hours), the dialysis session was postponed by one day, without systemic consequences. Finally, we report the case of a female patient admitted to intensive care unit for dyspnoea, underwent emergency orotracheal intubation for acute respiratory failure and the case was considered suspect for SARS-CoV-2 infection; because of the improvement of the clinical conditions, she was extubated, transferred to medicine department and a COVID-19 swab resulted negative. Due to the onset of dysphonia following orotracheal intubation, she performed ENT evaluation with diagnosis of left vocal cord impaired mobility in malignant laryngeal tumor.