Preoperative Chest Computed Tomography Screening for Coronavirus Disease 2019 in Asymptomatic Patients Undergoing Cardiac Surgery
| Autor: | Ad J.J.C. Bogers, Wiebe G. Knol, Arlette E. Odink, Daniel Thuijs, Pál Maurovich-Horvat, Ricardo P.J. Budde, Pim A. de Jong, Gabriel P. Krestin |
|---|---|
| Přispěvatelé: | Radiology & Nuclear Medicine, Cardiothoracic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Population 030204 cardiovascular system & hematology Asymptomatic Preoperative screening 03 medical and health sciences 0302 clinical medicine RT-PCR reverse-transcriptase polymerase-chain reaction test medicine Clinical endpoint Humans Mass Screening Cardiac Surgical Procedures education Computed tomography Mass screening COVID-19 coronavirus disease education.field_of_study business.industry SARS-CoV-2 ADULT – Original Submission COVID-19 General Medicine Cardiac surgery SARS-Cov-2 the novel coronavirus Confidence interval CT computed tomography 030228 respiratory system Cohort Surgery Observational study Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Tomography X-Ray Computed |
| Zdroj: | Seminars in Thoracic and Cardiovascular Surgery Seminars in Thoracic and Cardiovascular Surgery, 33(2), 417-424. W.B. Saunders |
| ISSN: | 1532-9488 1043-0679 |
| Popis: | Due to the outbreak of Severe Acute Respiratory Syndrome coronavirus (SARS-Cov-2), an efficient COVID-19 screening strategy is required for patients undergoing cardiac surgery. The objective of this prospective observational study was to evaluate the role of preoperative computed tomography (CT) screening for COVID-19 in a population of COVID-19 asymptomatic patients scheduled for cardiac surgery. Between the 29th of March and the 26th of May 2020, patients asymptomatic for COVID-19 underwent a CT-scan the day before surgery, with reverse-transcriptase polymerase-chain reaction (RT-PCR) reserved for abnormal scan results. The primary endpoint was the prevalence of abnormal scans, which was evaluated using the CO-RADS score, a COVID-19 specific grading system. In a secondary analysis, the rate of abnormal scans was compared between the screening cohort and matched historical controls who underwent routine preoperative CT-screening prior to the SARS-Cov-2 outbreak. Of the 109 patients that underwent CT-screening, an abnormal scan result was observed in 7.3% (95% confidence interval: 3.2–14.0%). One patient, with a normal screening CT, was tested positive for COVID-19, with the first positive RT-PCR on the ninth day after surgery. A rate of preoperative CT-scan abnormalities of 8% (n = 8) was found in the unexposed historical controls (P > 0.999). In asymptomatic patients undergoing cardiac surgery, preoperative screening for COVID-19 using computed tomography will identify pulmonary abnormalities in a small percentage of patients that do not seem to have COVID-19. Depending on the prevalence of COVID-19, this results in an unfavorable positive predictive value of CT screening. Care should be taken when considering CT as a screening tool prior to cardiac surgery. Graphical Abstract Image, graphical abstract |
| Databáze: | OpenAIRE |
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