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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
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]