ABSTRACT
Introduction This study aimed to evaluate the role of chest computed tomography (CT) in complementing reverse transcription polymerase chain reaction (RT-PCR) in asymptomatic candidates for elective surgery in the context of the COVID-19 pandemic. Material and methods We prospectively included 464 asymptomatic patients who underwent a triple screening workup for SARS-CoV-2 infection (health questionnaire, RT-PCR, and low-dose chest CT) during the 48 hours prior to undergoing elective surgery. A positive RT-PCR and/or CT findings suggestive of COVID-19 (CO-RADS 4 / 5) were considered diagnostic criteria for SARS-CoV-2 infection. Results Most patients (64.7%) underwent otorhinolaryngology surgery. No patients had positive RT-PCR results or symptoms suggestive of SARS-CoV-2 in the health questionnaire. Only 22 (4.7%) had signs compatible with lung infection;in 20 of these, the CT findings were atypical or indeterminate for COVID-19 (CO-RADS 2 / 3) and in 2 they were compatible with COVID-19 pneumonia in resolution. In the immediate postoperative period, no cases of SARS-CoV-2 infection were confirmed. Conclusion In our series of asymptomatic patients, low-dose CT did not add any value to the results of RT-PCR and a health questionnaire in preoperative screening for SARS-CoV-2.
ABSTRACT
INTRODUCTION: This study aimed to evaluate the role of chest computed tomography (CT) in complementing reverse transcription polymerase chain reaction (RT-PCR) in asymptomatic candidates for elective surgery in the context of the COVID-19 pandemic. MATERIAL AND METHODS: We prospectively included 464 asymptomatic patients who underwent a triple screening workup for SARS-CoV-2 infection (health questionnaire, RT-PCR, and low-dose chest CT) during the 48 h prior to undergoing elective surgery. A positive RT-PCR and/or CT findings suggestive of COVID-19 (CO-RADS 4/5) were considered diagnostic criteria for SARS-CoV-2 infection. RESULTS: Most patients (64.7%) underwent otorhinolaryngology surgery. No patients had positive RT-PCR results or symptoms suggestive of SARS-CoV-2 in the health questionnaire. Only 22 (4.7%) had signs compatible with lung infection; in 20 of these, the CT findings were atypical or indeterminate for COVID-19 (CO-RADS 2/3) and in 2 they were compatible with COVID-19 pneumonia in resolution. In the immediate postoperative period, no cases of SARS-CoV-2 infection were confirmed. CONCLUSION: In our series of asymptomatic patients, low-dose CT did not add any value to the results of RT-PCR and a health questionnaire in preoperative screening for SARS-CoV-2.
Subject(s)
COVID-19 , Humans , Pandemics , SARS-CoV-2 , Tomography, X-Ray ComputedABSTRACT
Introduction: This study aimed to evaluate the role of chest computed tomography (CT) in complementing reverse transcription polymerase chain reaction (RT-PCR) in asymptomatic candidates for elective surgery in the context of the COVID-19 pandemic. Material and methods: We prospectively included 464 asymptomatic patients who underwent a triple screening workup for SARS-CoV-2 infection (health questionnaire, RT-PCR, and low-dose chest CT) during the 48 hours prior to undergoing elective surgery. A positive RT-PCR and/or CT findings suggestive of COVID-19 (CO-RADS 4 / 5) were considered diagnostic criteria for SARS-CoV-2 infection. Results: Most patients (64.7%) underwent otorhinolaryngology surgery. No patients had positive RT-PCR results or symptoms suggestive of SARS-CoV-2 in the health questionnaire. Only 22 (4.7%) had signs compatible with lung infection; in 20 of these, the CT findings were atypical or indeterminate for COVID-19 (CO-RADS 2 / 3) and in 2 they were compatible with COVID-19 pneumonia in resolution. In the immediate postoperative period, no cases of SARS-CoV-2 infection were confirmed. Conclusion: In our series of asymptomatic patients, low-dose CT did not add any value to the results of RT-PCR and a health questionnaire in preoperative screening for SARS-CoV-2.
ABSTRACT
Introducción: El objetivo del presente estudio fue evaluar el papel de la tomografía computarizada (TC) de tórax complementaria a la prueba de la reacción en cadena de la polimerasa con transcripción inversa (RT-PCR) en pacientes asintomáticos candidatos a cirugía electiva en el contexto de la pandemia de COVID-19. Material y métodos: Se incluyeron, de forma prospectiva, 464 pacientes asintomáticos que se sometieron a una triple estrategia de cribado de infección por SARS-CoV-2 (cuestionario de salud, prueba de RT-PCR y TC torácica de baja dosis) durante las 48 horas previas a la realización de una cirugía electiva. Un resultado positivo en la prueba de RT-PCR y/o la identificación de hallazgos tomográficos sugestivos de neumonía COVID-19 (categorías CO-RADS 4 y 5) fueron considerados criterios diagnósticos de infección por SARS-CoV-2. Resultados: La mayor parte de los pacientes se sometieron a cirugías de otorrinolaringología (64,7%). Ningún paciente presentó un resultado positivo en la prueba de RT-PCR ni síntomas sugestivos de infección por SARS-CoV-2 en el cuestionario de salud. Únicamente 22 (4,7%) mostraron signos compatibles con infección pulmonar;20 de ellos atípica o indeterminada para COVID-19 (CO-RADS 2, 3) y 2 compatibles con neumonía COVID-19 en resolución. Durante el postoperatorio inmediato no se confirmó ningún caso positivo para SARS-CoV-2. Conclusión: En nuestra serie, la realización de una TC torácica de baja dosis de radiación en pacientes asintomáticos para el cribado preoperatorio de infección por SARS-CoV-2 no proporcionó un valor diagnóstico adicional a la RT-PCR y el cuestionario de salud.
Subject(s)
COVID-19 , Exanthema , Skin Diseases, Viral , Hospitalization , Humans , SARS-CoV-2 , Tertiary Care CentersABSTRACT
Background: Cutaneous manifestations have been associated with COVID-19 infection and their clinical significance in hospitalized patients remains unclear. Methods: A retrospective chart review of 1216 patients older than 18 years of age hospitalized with laboratory-confirmed SARS-CoV-2 infection from March 12, 2020 to May 31, 2020 at a large urban academic medical center. A keyword search query of patient records combined with manual chart review by at least two dermatologists identified a study group having cutaneous manifestations concurrent with COVID-19 infection, specifically between 14 days prior to admission and up to discharge. Results: 122 patients with 195 skin lesions concurrent with COVID-19 hospitalization were identified. Dermatology reviewers evaluated clinical photographs for 116 lesions (59.5%) and inpatient dermatology consultations for 42 lesions (21.5%). The most common cutaneous findings in patients with COVID-19 hospitalization were pressure injuries (n=118;60.5%) and morbilliform eruptions (n=33;16.9%). A very small number of patients (0.6%;n=7/1216) had exanthems occurring within 2 weeks of COVID-19 symptom onset. The majority of exanthems developed within 14 days of exposure to possible culprit drugs and beyond the 14-day window of COVID-19 symptom onset, making viral association unlikely. Conclusion: Skin lesions concurrent with COVID-19 hospitalization were most frequently linked to hospitalization-related factors, such as pressure injuries or drug-related exanthems, rather than due to novel pathologies related to SARS-CoV-2 itself.