Transmission of infection among health care personnel performing surgical tracheostomies on COVID-19 patients

Abstract Background Staff and patient safety are of paramount importance while performing a surgical tracheostomy(ST) during the corona virus disease(COVID-19) pandemic. The aim was to assess the incidence of COVID-19 infection among the healthcare personnel(HCP) performing ST on COVID-19 patients. Methods One hundred and twenty-two HCP participating in 71 ST procedures performed at our institution between 26th March 2020 and 27th May 2020 were identified. A COVID-19 health questionnaire was distributed among staff with their consent. Data related to the presence of COVID-19 symptoms(new onset continuous cough, fever, loss of taste and/or loss of smell) among HCP involved in ST as well as patient related data were collected. Results Of the HCP who responded, eleven(15%,11/72) reported key COVID-19 symptoms and went into self-isolation. Ten members from this group underwent a COVID-19 swab test and three tested positive. Only one HCP attended hospital for symptomatic treatment, none required hospitalisation. Sixty percent(43/72) of the responders had a COVID-19 antibody test with a positive rate of 18.6%(8/43). Among the patients undergoing a ST, 67%(37/55) required a direct intensive care unit(ICU) admission; the mean age was 58 years(29-78) with a male preponderance(65.5%). The median time from intubation to ST was 15 days (range 5-33,IQR=9). The overall mortality was 11%(6/55). Conclusions ST can be carried out safely with strict adherence to both, personnel protective equipment and ST protocols which are vital to mitigate the potential transmission of COVID-19 to the HCP.