Yield of Screening for COVID-19 in Asymptomatic Patients Prior to Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study

Objective: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms Summary Background Data: Many centers are currently screening surgical patients for COVID-19 using either chest CT, RT-PCR or both, due to the risk for worsened surgical outcomes and nosocomial spread The optimal design and yield of such a strategy are currently unknown Methods: This multicenter study included consecutive adult patients without COVID-19 symptoms who underwent preoperative screening using chest CT and RT-PCR before elective or emergency surgery under general anaesthesia Results: A total of 2093 patients without COVID-19 symptoms were included in 14 participating centers;1224 were screened by CT and RT-PCR and 869 by chest CT only The positive yield of screening using a combination of chest CT and RT-PCR was 1 5% (95%CI: 0 8–2 1) Individual yields were 0 7% (95%CI: 0 2–1 1) for chest CT and 1 1% (95%CI: 0 6–1 7) for RT-PCR;the incremental yield of chest CT was 0 4% In relation to COVID-19 community prevalence, up to ∼6% positive RT-PCR was found for a daily hospital admission rate >1 5 per 100,000 inhabitants, and around 1 0% for lower prevalence Conclusions: One in every 100 patients without COVID-19 symptoms tested positive for SARS-CoV-2 with RT-PCR;this yield increased in conjunction with community prevalence The added value of chest CT was limited Preoperative screening allowed us to take adequate precautions for SARS-CoV-2 positive patients in a surgical population, whereas negative patients needed only routine procedures j stoker@amsterdamumc nl CAJP, JCGS and ABJB: Shared first authorship;these authors contributed equally to this article SSG, JMP, MGB, MAB, HAG and JS: Shared last authorship;these authors contributed equally to this article Conflicts of Interest and Source of Funding: De Hingh has an unrestricted research fund from RanD Biotech and Roche for research non-related to current manuscript and paid to the institute Van Berge Henegouwen is consultant for Mylan, Johnson and Johnson and received research grants from Olympus and Stryker paid to the institute All authors declare no competing interests No external funding was received for this study Supplemental digital content is available for this article Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www annalsofsurgery com) Copyright © 2020 Wolters Kluwer Health, Inc All rights reserved