Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure

Huybens, E M; Bus, Michaël P. A.; Massaad, Rachid; Wijers, L; Voet, Joeri; Delfos, Nathalie M; Feltz, M. van der; Heemstra, Karen A.; Koch, S M P

doi:10.1002/bjs.11822

Cited by 7 publications

(7 citation statements)

References 5 publications

(6 reference statements)

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“…A typical HRCT picture of COVID-19 pneumonia as reported by recent studies shows GGO with concomitant multifocal patchy consolidates or interstitial or parenchymal changes [7]. Similar findings in HRCT of patients with negative RRT-PCR reports were observed indicating that HRCT can diagnose the abnormalities in the lung of patients infected with COVID-19 even when PCR is false negative [12]. A meta-analysis has concluded the sensitivity of RT-PCR on the nasopharyngeal swab and HRCT chest 68.1% to 78% and 91.9%, respectively, but, the accuracy of RT-PCR depends on the adequacy of sample and duration of illness and takes hours in reporting [9,10].…”

Section: Discussionsupporting

confidence: 79%

Comparison of High-Resolution Computed Tomography and Real-Time Reverse Transcriptase Polymerase Chain Reaction in Diagnosis of COVID-19 Pneumonia in Intensive Care Unit Population

Murtaza¹,

Javed²,

Iqbal³

et al. 2021

Cureus

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Introduction The efficacy of high-resolution computed tomography (HRCT) chest in common respiratory infections is well-established; however, its use in the diagnosis of COVID-19 pneumonia is less popular. The previous studies have failed to establish the efficacy of HRCT in the diagnosis of COVID-19 pneumonia. Objective The current study aimed to assess the efficacy of HRCT as compared to a polymerase chain reaction (PCR) in diagnosing COVID-19 pneumonia in patients in our setting. Methodology A prospective observational study was conducted at the Department of Chest Medicine, Shifa International Hospital from April 2020 to December 2020. A total of 250 patients were admitted to medical intensive care units. Findings of HRCT and PCR were documented. The accuracy of HRCT compared with PCR was assessed. Data were analyzed using SPSS version 24 (IBM Corp., Armonk, NY). Results COVID-19 infection was more prevalent in male patients (62.8% vs 37.2%). The mean age was 60 years (interquartile range, IQR, 49-72). Sensitivity and specificity of HRCT segregated into typical, indeterminate, and atypical HRCT were (94.8%, 56.8%), (92.7%, 47.2%), and (91.7%, 76.8%), respectively. The positive predictive value for typical HRCT was 84.3% (p≤0.001). Conclusion We concluded that typical HRCT findings have diagnostic utility in the diagnosis of COVID pneumonia. Similarly, a negative HRCT chest reliably excludes the possibility of COVID pneumonia. HRCT chest is a reliable alternative to RT-PCR.

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Section: Discussionsupporting

confidence: 79%

Comparison of High-Resolution Computed Tomography and Real-Time Reverse Transcriptase Polymerase Chain Reaction in Diagnosis of COVID-19 Pneumonia in Intensive Care Unit Population

Murtaza¹,

Javed²,

Iqbal³

et al. 2021

Cureus

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“…This corroborates the findings of a multicentre study of 2093 patients undergoing surgery in the Netherlands, in which the incremental yield of thoracic CT in asymptomatic patients was slight, at 0.4 per cent 9 . Similarly, in a small series 22 , high-resolution CT chest added very little additional value and a high resource cost, with just 3 of 386 patients with a negative swab who had thoracic CT having surgery postponed.…”

Section: Discussionmentioning

confidence: 99%

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic

Collaborative

2020

British Journal of Surgery

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Background Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. Methods This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. Results Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. Conclusion Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas.

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“… 10 Additionally, using a high resolution computed tomography of the thorax (HRCT thorax) may help augment the screening procedure given false-negative results of the RT-PCR test. 13 , 14 Emergency procedures may be an exception to these, however in such cases where the patient's life may depend on an instantaneous decision, screening with a pre-tested questionnaire is usually done.…”

Section: Is Covid Testing Included Routinely As Part Of Pre-operativementioning

confidence: 99%

Searching for answers: Cancer care during the COVID pandemic

Rajan¹,

Chakrabarti²,

Akhtar³

et al. 2021

Clinical Epidemiology and Global Health

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Screening with HRCT chest and PCR testing for COVID-19 in asymptomatic patients undergoing a surgical or diagnostic procedure

Cited by 7 publications

References 5 publications

Comparison of High-Resolution Computed Tomography and Real-Time Reverse Transcriptase Polymerase Chain Reaction in Diagnosis of COVID-19 Pneumonia in Intensive Care Unit Population

Comparison of High-Resolution Computed Tomography and Real-Time Reverse Transcriptase Polymerase Chain Reaction in Diagnosis of COVID-19 Pneumonia in Intensive Care Unit Population

Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic

Searching for answers: Cancer care during the COVID pandemic

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