Background&objectives: Coronavirus disease 19 (COVID-19) has
been declared by World Health Organization as a global pandemic disease in
March 2020. Acute respiratory distress syndrome is frequent complication of COVID-19
disease. Tracheostomy is needed in cases of prolonged mechanical ventilation (7-10 days) in patients with acute respiratory distress
syndrome. Tracheostomies are highly aerosol generating procedures,
Otorhinolaryngologists and Health Care Workers (HCWs) are at high risk of virus
exposure. The aim of this review is to evaluate the risk of transmission of
COVID-19 during tracheostomy procedure, and to review the practical
recommendation and scope of the timing to reduce risk of transmission to HCW. Methods: PubMed database was searched between April 2020 to Jan 2021 using the terms
“Tracheostomy AND COVID-19 AND Health Care Workers”. All the articles that
shared the same aim were screened which resulted in 243 references without
duplicates. The title and abstract screening excluded further 202 studies.
Eventually 9 full-text studies were included. Results: Five hundred and
two COVID-19 patients underwent tracheostomies during the study period. Sixty-three
percent of the procedure were done through open technique, while 37% of them
were done through percutaneous technique. Seventy-eight percent of them used
full Personal Protective Equipment (PPE) and 44.4% used Powered Air Purifying
Respirator (PAPR). Negative Pressure Rooms (NPR) were used in 67%. Conclusion: The studies showed similar negative results on HCW infection despite much
variance in using PPE. However, there should be global unified recommendations
and guidelines regarding tracheostomies in COVID-19 patients to prevent future
HCW infection.
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