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

Autor:	Puylaert CAJ; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Scheijmans JCG; Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Borgstein ABJ; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Andeweg CS; Department of Surgery, St Jansdal Hospital, Harderwijk, the Netherlands., Bartels-Rutten A; Department of Radiology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Beets GL; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., van Berge Henegouwen MI; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Braak SJ; Department of Radiology, Hospital Group Twente, Almelo, the Netherlands., Couvreur R; Department of Surgery, Haaglanden Medical Center, Den Haag, the Netherlands., Daams F; Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands., van Es HW; Department of Radiology, Sint Antonius Hospital, Nieuwegein, the Netherlands., Franken LC; Department of Surgery, Flevo Hospital, Almere, the Netherlands., Grotenhuis BA; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Hendriks ER; Department of Surgery, Tergooi Hospitals, Hilversum, the Netherlands., de Hingh IHJT; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Hoeijmakers F; Department of Surgery, Dijklander Hospital, Hoorn, the Netherlands., Ten Holder JT; Department of Pulmonary Medicine, Haaglanden Medical Center, Den Haag, the Netherlands., Huisman PM; Department of Radiology, Tergooi Hospitals, Hilversum, the Netherlands., Kazemier G; Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands., van Kesteren F; Department of Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., van Kesteren J; Department of Surgery, Dijklander Hospital, Hoorn, the Netherlands., Keywani K; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Kuiper SZ; Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands., Lange MDJ; Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Lobatto ME; Department of Radiology, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands., du Mée AWF; Department of Radiology, Amphia Hospital, Breda, the Netherlands., Poeze M; Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands., van Praag EM; Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., van Rossen J; Department of Radiology, Hospital Group Twente, Almelo, the Netherlands., van Santvoort HC; Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands.; Department of Surgery, UMC Utrecht Cancer Center, UMC Utrecht, Utrecht, the Netherlands., Sedee WJA; Department of Emergency Medicine, St Jansdal Hospital, Harderwijk, the Netherlands., Seelen LWF; Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands., Sharabiany S; Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Sosef NL; Department of Surgery, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands., Quanjel MJR; Department of Pulmonary Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands., Veltman J; Department of Radiology, Hospital Group Twente, Almelo, the Netherlands., Verhagen T; Department of Surgery, Hospital Group Twente, Almelo, the Netherlands., van de Vlasakker VCJ; Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands., Weeder PD; Department of Surgery, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands., van Werven JR; Department of Radiology, Amphia Hospital, Breda, the Netherlands., Wesdorp NJ; Department of Surgery, Cancer Center Amsterdam UMC, VU University Amsterdam, Amsterdam, the Netherlands., van Dieren S; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Han AX; Laboratory of Applied Evolutionary Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Russell CA; Laboratory of Applied Evolutionary Biology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., de Jong MD; Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Bossuyt PMM; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Quarles van Ufford JME; Department of Radiology, Haaglanden Medical Center, Den Haag, the Netherlands., Prokop MW; Department of Radiology, Radboud UMC, Nijmegen, the Netherlands., Gisbertz SS; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Prins JM; Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Besselink MG; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Boermeester MA; Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Gietema HA; Department of Radiology, Maastricht UMC+, Maastricht, the Netherlands., Stoker J; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2020 Dec; Vol. 272 (6), pp. 919-924.
DOI:	10.1097/SLA.0000000000004218
Abstrakt:	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 ∼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.
Databáze:	MEDLINE
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