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.
2020-10-21T19:49:39Z
2020-10-21T19:49:39Z
2020
1043-0679
https://doi.org/10.1053/j.semtcvs.2020.09.027
http://hdl.handle.net/20.500.12010/14668
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.
8 páginas
application/pdf
eng
Seminars
reponame:Expeditio Repositorio Institucional UJTL
instname:Universidad de Bogotá Jorge Tadeo Lozano
Coronavirus Disease 2019
Patients Undergoing
Cardiac Surgery
Preoperative chest computed tomography screening for coronavirus disease 2019 in asymptomatic patients undergoing cardiac surgery
Artículo
Síndrome respiratorio agudo grave
COVID-19
SARS-CoV-2
Coronavirus
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/acceptedVersion
Abierto (Texto Completo)
https://doi.org/10.1053/j.semtcvs.2020.09.027
http://purl.org/coar/resource_type/c_2df8fbb1