Dataset Information

Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.

ABSTRACT: OBJECTIVE:To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms. SUMMARY OF BACKGROUND DATA:Many centers are currently screening surgical patients for COVID-19 using either chest CT, RT-PCR or both, due to the risk for worsened surgical outcomes and nosocomial spread. The optimal design and yield of such a strategy are currently unknown. METHODS:This multicenter study included consecutive adult patients without COVID-19 symptoms who underwent preoperative screening using chest CT and RT-PCR before elective or emergency surgery under general anesthesia. RESULTS:A total of 2093 patients without COVID-19 symptoms were included in 14 participating centers; 1224 were screened by CT and RT-PCR and 869 by chest CT only. The positive yield of screening using a combination of chest CT and RT-PCR was 1.5% [95% confidence interval (CI): 0.8-2.1]. Individual yields were 0.7% (95% CI: 0.2-1.1) for chest CT and 1.1% (95% CI: 0.6-1.7) for RT-PCR; the incremental yield of chest CT was 0.4%. In relation to COVID-19 community prevalence, up to ?6% positive RT-PCR was found for a daily hospital admission rate >1.5 per 100,000 inhabitants, and around 1.0% for lower prevalence. CONCLUSIONS:One in every 100 patients without COVID-19 symptoms tested positive for SARS-CoV-2 with RT-PCR; this yield increased in conjunction with community prevalence. The added value of chest CT was limited. Preoperative screening allowed us to take adequate precautions for SARS-CoV-2 positive patients in a surgical population, whereas negative patients needed only routine procedures.

SUBMITTER: Puylaert CAJ

PROVIDER: S-EPMC7668335 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.

Puylaert Carl A J CAJ Scheijmans Jochem C G JCG Borgstein Alexander B J ABJ Andeweg Caroline S CS Bartels-Rutten Annemarieke A Beets Geerard L GL van Berge Henegouwen Mark I MI Braak Sicco J SJ Couvreur Roy R Daams Freek F van Es Hendrik W HW Franken Lotte C LC Grotenhuis Brechtje A BA Hendriks Eduard R ER de Hingh Ignace H J T IHJT Hoeijmakers Fieke F Ten Holder Joris T JT Huisman Peter M PM Kazemier Geert G van Kesteren Floortje F van Kesteren Jurre J Keywani Kammy K Kuiper Sara Z SZ Lange Maurits D J MDJ Lobatto Mark E ME du Mée Arthur W F AWF Poeze Martijn M van Praag Elise M EM van Rossen Jorit J van Santvoort Hjalmar C HC Sedee Wouter J A WJA Seelen Leonard W F LWF Sharabiany Sarah S Sosef Nico L NL Quanjel Marian J R MJR Veltman Jeroen J Verhagen Tim T van de Vlasakker Vincent C J VCJ Weeder Pepijn D PD van Werven Jochem R JR Wesdorp Nina J NJ van Dieren Susan S Han Alvin X AX Russell Colin A CA de Jong Menno D MD Bossuyt Patrick M M PMM Quarles van Ufford Jet M E JME Prokop Mathias W MW Gisbertz Suzanne S SS Prins Jan M JM Besselink Marc G MG Boermeester Marja A MA Gietema Hester A HA Stoker Jaap J

Annals of surgery 20201201 6

<h4>Objective</h4>To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.<h4>Summary of background data</h4>Many centers are currently screening surgical patients for COVID-19 using either chest CT, RT-PCR or both, due to the risk for worsened surgical outcomes and nosocomial spread. The optimal design and yield of such a strategy are currently unknown.<h4>Methods</h4>This multicenter study included consecutive adult patients ...[more]

PMID: 33021367

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Project description:Background Chest CT is used in the diagnosis of coronavirus disease 2019 (COVID-19) and is an important complement to reverse-transcription polymerase chain reaction (RT-PCR) tests. Purpose To investigate the diagnostic value and consistency of chest CT as compared with RT-PCR assay in COVID-19. Materials and Methods This study included 1014 patients in Wuhan, China, who underwent both chest CT and RT-PCR tests between January 6 and February 6, 2020. With use of RT-PCR as the reference standard, the performance of chest CT in the diagnosis of COVID-19 was assessed. In addition, for patients with multiple RT-PCR assays, the dynamic conversion of RT-PCR results (negative to positive, positive to negative) was analyzed as compared with serial chest CT scans for those with a time interval between RT-PCR tests of 4 days or more. Results Of the 1014 patients, 601 of 1014 (59%) had positive RT-PCR results and 888 of 1014 (88%) had positive chest CT scans. The sensitivity of chest CT in suggesting COVID-19 was 97% (95% confidence interval: 95%, 98%; 580 of 601 patients) based on positive RT-PCR results. In the 413 patients with negative RT-PCR results, 308 of 413 (75%) had positive chest CT findings. Of those 308 patients, 48% (103 of 308) were considered as highly likely cases and 33% (103 of 308) as probable cases. At analysis of serial RT-PCR assays and CT scans, the mean interval between the initial negative to positive RT-PCR results was 5.1 days ± 1.5; the mean interval between initial positive to subsequent negative RT-PCR results was 6.9 days ± 2.3. Of the 1014 patients, 60% (34 of 57) to 93% (14 of 15) had initial positive CT scans consistent with COVID-19 before (or parallel to) the initial positive RT-PCR results. Twenty-four of 57 patients (42%) showed improvement on follow-up chest CT scans before the RT-PCR results turned negative. Conclusion Chest CT has a high sensitivity for diagnosis of coronavirus disease 2019 (COVID-19). Chest CT may be considered as a primary tool for the current COVID-19 detection in epidemic areas. © RSNA, 2020 Online supplemental material is available for this article. A translation of this abstract in Farsi is available in the supplement. ترجمه چکیده این مقاله به فارسی، در ضمیمه موجود است.

Dataset Information

Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.

Publications

Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.

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