Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.
Ann Surg
; 272(6): 919-924, 2020 12.
Article
in English
| MEDLINE | ID: covidwho-1029777
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 â¼6% 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.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Surgical Procedures, Operative
/
Thorax
/
Preoperative Care
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Tomography, X-Ray Computed
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Mass Screening
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Reverse Transcriptase Polymerase Chain Reaction
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Emergency Treatment
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Asymptomatic Infections
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SARS-CoV-2
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COVID-19
Type of study:
Diagnostic study
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Experimental Studies
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Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Ann Surg
Year:
2020
Document Type:
Article
Affiliation country:
SLA.0000000000004218
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