Open AccessSARS-CoV-2 (COVID-19) PCR cycle threshold: can it help in the timing of urgent cardiac surgery?
Author(s) -
Abdulaziz Alkhulaifi,
Shady A. Mohammed,
Hafeez Lone,
Mohd Yaqoob Wani,
Bassam Shoman,
Mawahib Elhassan,
Asmaa Althani,
Cornelia S Carr
Publication year - 2020
Publication title -
jrsm open
Language(s) - English
Resource type - Journals
ISSN - 2054-2704
DOI - 10.1177/2054270420977365
Subject(s) - covid-19 , medicine , asymptomatic , cardiac surgery , reverse transcriptase , reverse transcription polymerase chain reaction , pneumonia , disease , polymerase chain reaction , cardiology , surgery , infectious disease (medical specialty) , biology , messenger rna , gene , biochemistry
Background The COVID-19 pandemic has resulted in a significant reduction in urgent cardiac surgery due to concerns about safety for both patients and care givers. The timing of safe cardiac surgery is yet to be clarified in the setting of COVID-19 diagnosis.Methods Due to the urgency of the cardiac conditions on presentation, we have operated on four patients who exhibited the spectrum of COVID-19 disease from asymptomatic to severe COVID-19 pneumonia. With the evolving knowledge about SARS-CoV-2 and its genetic determinants as well as the cycle threshold levels obtained from real-time reverse transcription polymerase chain reaction, we have attempted to develop a strategy to deal with these patients.Results All four patients underwent urgent cardiac surgery following a thorough evaluation and multidisciplinary team approach with guidance based on the virus cycle threshold values obtained by reverse transcription polymerase chain reaction.Conclusion We have shown that, with thorough preparations, consideration of the significance of the cycle threshold obtained on reverse transcription polymerase chain reaction and meticulous timing, COVID-19 diagnosed patients may undergo open heart surgery safely.