The utility of chest CT and RT-PCR screening of asymptomatic patients for SARS-CoV-2 (COVID-19) prior to semi-urgent or urgent hospital procedures

Link to article at PubMed

Infect Control Hosp Epidemiol. 2020 Jul 16:1-11. doi: 10.1017/ice.2020.331. Online ahead of print.


OBJECTIVE: At present, there is a paucity of evidence guiding clinicians on the optimal approach to safely screen patients for SARS-CoV-2 (COVID-19) infection prior to a non-emergent hospital procedure. In this report we describe our experience in screening for SARS-CoV-2 (COVID-19) prior to semi-urgent and urgent hospital procedures.

DESIGN: Retrospective case series.

SETTING: Single tertiary medical center.

PARTICIPANTS: Patients ≥ 18 years of age who had semi-urgent or urgent hospital procedures or surgeries.

METHODS: 625 patients were screened for SARS-CoV-2 (COVID-19) using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest CT, between 3/1/2020 and 4/30/2020.

RESULTS: Of the 625 patients, 520 scans (83.2%) were interpreted as normal, 1 (0.16%) as having typical features, 18 scans (2.88%) as having indeterminate features, and 86 (13.76%) as having atypical features of SARS-CoV-2 (COVID-19). A total of 640 RT-PCRs were performed, with 1 positive result (0.15%) in a patient with CT scan read as atypical. Out of 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab one week after their initial swab. 1 patient with chest CT categorized as typical had a follow up repeat negative RT-PCR, indicating that the chest CT was likely a false positive. None of the patients, after surgery, developed signs or symptoms suspicious of COVID-19, needing repeat RT-PCR or CT scan.

CONCLUSION: In our experience, chest CT scanning did not prove provide valuable information in detecting asymptomatic cases of SARS-CoV-2 (COVID-19) in our low prevalence population.

PMID:32669150 | DOI:10.1017/ice.2020.331

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