TY - JOUR
T1 - Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT) Multicenter Study
AU - Puylaert, Carl A. J.
AU - Scheijmans, Jochem C. G.
AU - Borgstein, Alexander B. J.
AU - Andeweg, Caroline S.
AU - Bartels-Rutten, Annemarieke
AU - Beets, Geerard L.
AU - van Berge Henegouwen, Mark I.
AU - Braak, Sicco J.
AU - Couvreur, Roy
AU - Daams, Freek
AU - van Es, Hendrik W.
AU - Franken, Lotte C.
AU - Grotenhuis, Brechtje A.
AU - Hendriks, Eduard R.
AU - de Hingh, Ignace H. J. T.
AU - Hoeijmakers, Fieke
AU - ten Holder, Joris T.
AU - Huisman, Peter M.
AU - Kazemier, Geert
AU - van Kesteren, Floortje
AU - van Kesteren, Jurre
AU - Keywani, Kammy
AU - Kuiper, Sara Z.
AU - Lange, Maurits D. J.
AU - Lobatto, Mark E.
AU - du Mee, Arthur W. F.
AU - Poeze, Martijn
AU - van Praag, Elise M.
AU - van Rossen, Jorit
AU - van Santvoort, Hjalmar C.
AU - Sedee, Wouter J. A.
AU - Seelen, Leonard W. F.
AU - Sharabiany, Sarah
AU - Sosef, Nico L.
AU - Quanjel, Marian J. R.
AU - Veltman, Jeroen
AU - Verhagen, Tim
AU - van de Vlasakker, Vincent C. J.
AU - Weeder, Pepijn D.
AU - van Werven, Jochem R.
AU - Wesdorp, Nina J.
AU - van Dieren, Susan
AU - Han, Alvin X.
AU - Russell, Colin A.
AU - de Jong, Menno D.
AU - Bossuyt, Patrick M. M.
AU - Quarles van Ufford, Jet M. E.
AU - Prokop, Mathias W.
AU - Gisbertz, Suzanne S.
AU - Gietema, Hester A.
AU - SCOUT Study Group
AU - Stoker, Jaap
PY - 2020/12
Y1 - 2020/12
N2 - 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 similar 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.
AB - 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 similar 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.
KW - COVID-19
KW - RT-PCR
KW - computed tomography
KW - preoperative screening
U2 - 10.1097/SLA.0000000000004218
DO - 10.1097/SLA.0000000000004218
M3 - Article
C2 - 33021367
SN - 0003-4932
VL - 272
SP - 919
EP - 924
JO - Annals of Surgery
JF - Annals of Surgery
IS - 6
ER -