Preoperative chest computed tomography screening for coronavirus disease 2019 in asymptomatic patients undergoing cardiac surgery
Date
2020Author
Knol, Wiebe G.
Thuijs, Daniel J.F.M.
Odink, Arlette E.
Maurovich-Horvat, Pal
Jong, Pim A. de
Krestin, Gabriel P.
Bogers, Ad J.J.C.
Budde, Ricardo P.J.
Metadata
Show full item recordAbstract
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.
Link to resource
https://doi.org/10.1053/j.semtcvs.2020.09.027Collections
Estadísticas Google Analytics
Comments
Respuesta Comentario Repositorio Expeditio
Gracias por tomarse el tiempo para darnos su opinión.