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

Infect Control Hosp Epidemiol. 2020 Dec;41(12):1375-1377. doi: 10.1017/ice.2020.331. Epub 2020 Jul 16.

Abstract

Objective: Presently, evidence guiding clinicians on the optimal approach to safely screen patients for coronavirus disease 2019 (COVID-19) to a nonemergent hospital procedure is scarce. In this report, we describe our experience in screening for SARS-CoV-2 prior to semiurgent and urgent hospital procedures.

Design: Retrospective case series.

Setting: A single tertiary-care medical center.

Participants: Our study cohort included patients ≥18 years of age who had semiurgent or urgent hospital procedures or surgeries.

Methods: Overall, 625 patients were screened for SARS-CoV-2 using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest computed tomography (CT) between March 1, 2020, and April 30, 2020.

Results: Of the 625 patients, 520 scans (83.2%) were interpreted as normal; 1 (0.16%) had typical features of COVID-19; 18 scans (2.88%) had indeterminate features of COVID-19; and 86 (13.76%) had atypical features of COVID-19. In total, 640 RT-PCRs were performed, with 1 positive result (0.15%) in a patient with a CT scan that yielded an atypical finding. Of the 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab 1 week after their initial swab. Also, 1 patient with a chest CT categorized as typical had a follow-up repeat negative RT-PCR, indicating that the chest CT was likely a false positive. After surgery, none of the patients developed signs or symptoms suspicious of COVID-19 that would indicate the need for a repeated 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.

MeSH terms

  • Adult
  • COVID-19 Nucleic Acid Testing* / methods
  • COVID-19 Nucleic Acid Testing* / statistics & numerical data
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Evidence-Based Practice
  • False Positive Reactions
  • Female
  • Humans
  • Infection Control / methods*
  • Male
  • Mass Screening / methods
  • Mass Screening / standards
  • Minnesota / epidemiology
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / etiology
  • SARS-CoV-2 / isolation & purification*
  • Safety Management
  • Surgery Department, Hospital / organization & administration
  • Tomography, X-Ray Computed / methods
  • Tomography, X-Ray Computed / standards
  • Tomography, X-Ray Computed / statistics & numerical data