Was Lung Computed Tomography Necessary for Patients Receiving Selective Surgery from Low-Risk Areas of COVID-19?

Background: Lung computed tomography (CT) image was considered assupplementary diagnostic criteria for COVID-19 in the newest diagnosis and treatment program; however, the diagnostic effectiveness of lung CT in patients that have a strict screening for symptoms, history and reverse transcription-polymerase chain reaction (RT-PCR) testing remain unclear. The purpose of this study was to share our experience about elective surgery during the COVID-19 pandemic and to analyze the effectiveness and necessity of lung CT for screening COVID-19 in elective surgery patients from low risk areas. Methods: Based on the database of our HospitalInformation System, all patients receiving elective surgery in departments of  general surgery, hepatological surgery, orthopedics, neurosurgery and urology at our hospital  from 11 January, 2020 to 11 May, 2020 were retrospectively involved. The general information, laboratory testing, comorbidities, reverse transcription-polymerase chain reaction (RT-PCR) and lung CT features were collected and analyzed. Findings: In total, 2375 patients (1150 females and 1225 males)were enrolled in this current study. The mean age was 52 years old, ranging from 6 to 94.All the RT-PCR results of these 2375 patients were negative, including the patients with fever.  The most common features on lung CT were nodular lesions (n=624, 26.3%) and striplike lesions (n=467, 19.7%). While, there were only  120 patients (5.1%) with ground-glass opacities (GGO) and 54 patients (2.3%) with lung consolidations on the lung CT, which were ruled out the COVID-19 by the RT-PCR results, clinical manifestation, fever screen, contact history and travel history. During the hospital stay, a total number of 1085 patients were screened with temperature ≥ 37.3 ℃ ,which were ruled out COVID-19 by consultation of special fever clinic and respiratory department. Interpretation: After strict screening for symptoms, history (contact COVID-19 patients or travelling to high-risk areas) and RT-PCR testing, lung CT image was not recommended as routine examination in patients receiving selective surgery from the low-risk areas of COVID-19. Funding: This work was supported by grants from the  Beijing Municipal Natural Science Foundation (No. 7192199), the Youth Support Project of Chinese PLA General Hospital (No. QNF19015) and  the National Key Research and Development Program of China (No. 2020YFC2004900). Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: The study was approved by the Medical Ethics Committee of the Chinese PLA General Hospital and performed in accordance with the ethical standards in the 1964 Declaration of Helsinki.