• Annals of surgery · Dec 2020

    Multicenter Study

    Yield of Screening for COVID-19 in Asymptomatic Patients Prior to Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study.

    • PuylaertCarl A JCAJDepartment of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Jochem C G Scheijmans, Alexander B J Borgstein, Caroline S Andeweg, Annemarieke Bartels-Rutten, Geerard L Beets, Mark I van Berge Henegouwen, Sicco J Braak, Roy Couvreur, Freek Daams, Hendrik W van Es, Lotte C Franken, Brechtje A Grotenhuis, Eduard R Hendriks, de HinghIgnace H J TIHJTDepartment of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Fieke Hoeijmakers, Joris T Ten Holder, Peter M Huisman, Geert Kazemier, Floortje van Kesteren, Jurre van Kesteren, Kammy Keywani, Sara Z Kuiper, Maurits D J Lange, Mark E Lobatto, du MéeArthur W FAWFDepartment of Radiology, Amphia Hospital, Breda, the Netherlands., Martijn Poeze, Elise M van Praag, Jorit van Rossen, Hjalmar C van Santvoort, Wouter J A Sedee, Leonard W F Seelen, Sarah Sharabiany, Nico L Sosef, Marian J R Quanjel, Jeroen Veltman, Tim Verhagen, Vincent C J van de Vlasakker, Pepijn D Weeder, Jochem R van Werven, Nina J Wesdorp, Susan van Dieren, Alvin X Han, Colin A Russell, Menno D de Jong, BossuytPatrick M MPMMDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Quarles van UffordJet M EJMEDepartment of Radiology, Haaglanden Medical Center, Den Haag, the Netherlands., Mathias W Prokop, Suzanne S Gisbertz, Jan M Prins, Marc G Besselink, Marja A Boermeester, Hester A Gietema, Jaap Stoker, and SCOUT study group.
    • Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
    • Ann. Surg. 2020 Dec 1; 272 (6): 919924919-924.

    ObjectiveTo determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.Summary Of Background DataMany 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.MethodsThis 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.ResultsA 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 ∼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.ConclusionsOne 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.

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