The utility of chest CT and RT-PCR screening of asymptomatic patients for SARS-CoV-2 (COVID-19) prior to semi-urgent or urgent hospital procedures

OBJECTIVE: At present, there is a paucity of evidence guiding clinicians on the optimal approach to safely screen patients for SARS-CoV-2 (COVID-19) infection prior to a non-emergent hospital procedure In this report we describe our experience in screening for SARS-CoV-2 (COVID-19) prior to semi-urgent and urgent hospital procedures DESIGN: Retrospective case series SETTING: Single tertiary medical center PARTICIPANTS: Patients ≥ 18 years of age who had semi-urgent or urgent hospital procedures or surgeries METHODS: 625 patients were screened for SARS-CoV-2 (COVID-19) using a combination of phone questionnaire (7 days prior to the anticipated procedure), RT-PCR and chest CT, between 3/1/2020 and 4/30/2020 RESULTS: Of the 625 patients, 520 scans (83 2%) were interpreted as normal, 1 (0 16%) as having typical features, 18 scans (2 88%) as having indeterminate features, and 86 (13 76%) as having atypical features of SARS-CoV-2 (COVID-19) A total of 640 RT-PCRs were performed, with 1 positive result (0 15%) in a patient with CT scan read as atypical Out of 18 patients with chest CTs categorized as indeterminate, 5 underwent repeat negative RT-PCR nasopharyngeal swab one week after their initial swab 1 patient with chest CT categorized as typical had a follow up repeat negative RT-PCR, indicating that the chest CT was likely a false positive None of the patients, after surgery, developed signs or symptoms suspicious of COVID-19, needing repeat 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