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Preprocedural SARS-CoV-2 Testing to Sustain Medically Needed Health Care Delivery During the COVID-19 Pandemic: A Prospective Observational Study.
Haidar, Ghady; Ayres, Ashley; King, Wendy C; McDonald, Mackenzie; Wells, Alan; Mitchell, Stephanie L; Bilderback, Andrew L; Minnier, Tami; Mellors, John W.
  • Haidar G; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Ayres A; Division of Infectious Diseases, UPMC, Pittsburgh, Pennsylvania, USA.
  • King WC; Division of Hospital Epidemiology and Infection Control, UPMC, Pittsburgh, Pennsylvania, USA.
  • McDonald M; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
  • Wells A; University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Mitchell SL; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Bilderback AL; Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Minnier T; Wolff Center, UPMC, Pittsburgh, Pennsylvania, USA.
  • Mellors JW; Wolff Center, UPMC, Pittsburgh, Pennsylvania, USA.
Open Forum Infect Dis ; 8(2): ofab022, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1091225
Semantic information from SemMedBD (by NLM)
1. Hospitals LOCATION_OF Prospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Prospective Studies
2. Screening procedure ADMINISTERED_TO Patients
Subject
Screening procedure
Predicate
ADMINISTERED_TO
Object
Patients
3. Hospitals LOCATION_OF Prospective Studies
Subject
Hospitals
Predicate
LOCATION_OF
Object
Prospective Studies
4. Screening procedure ADMINISTERED_TO Patients
Subject
Screening procedure
Predicate
ADMINISTERED_TO
Object
Patients
ABSTRACT

BACKGROUND:

We implemented a preprocedural severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) screening initiative designed to sustain health care during a time when the extent of SARS-CoV-2 infection was unknown.

METHODS:

This was a prospective study of patients undergoing procedures at 3 academic hospitals in Pittsburgh, Pennsylvania (April 21-June 11), and 19 community hospitals across Middle/Western Pennsylvania and Southwestern New York (May 1-June 11). Patients at academic hospitals underwent symptom screening ≤7 days preprocedure, then SARS-CoV-2 nasopharyngeal polymerase chain reaction (PCR) testing 1-4 days preprocedure. A subset also underwent day-of-procedure testing. Community hospital patients underwent testing per local protocols. We report SARS-CoV-2 PCR positivity rates, impact, and barriers to testing encountered through June 11. PCR positivity rates of optional preprocedural SARS-CoV-2 testing for 2 consecutive periods following the screening initiative are also reported.

RESULTS:

Of 5881 eligible academic hospital patients, 2415 (41.1%) were tested (April 21-June 11). Lack of interest, distance, self-isolation, and nursing home/incarceration status were barriers. There were 11 PCR-positive patients (10 asymptomatic) among 10 539 patients tested (0.10%; 95% CI, 0.05%-0.19%) 3/2415 (0.12%; 95% CI, 0.02%-0.36%) and 8/8124 (0.10%; 95% CI, 0.04%-0.19%) at academic and community hospitals, respectively. Procedures were performed as scheduled in 40% (4/10) of asymptomatic PCR-positive patients. Positivity increased during subsequent coronavirus disease 2019 (COVID-19) surges 54/34 948 (0.15%; 95% CI, 0.12%-0.20%) and 101/24 741 (0.41%; 95% CI, 0.33%-0.50%) PCR-positive patients from June 12-September 10 and September 11-December 15, respectively (P < .0001).

CONCLUSIONS:

Implementing preprocedural PCR testing was complex and revealed low infection rates (0.24% overall), which increased during COVID-19 surges. Additional studies are needed to define the COVID-19 prevalence threshold at which universal preprocedural screening is warranted.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Language: English Journal: Open Forum Infect Dis Year: 2021 Document Type: Article Affiliation country: Ofid