Preoperative computerized tomography screening for COVID-19 pneumonia in asymptomatic patients: experiences from two cen
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ORIGINAL ARTICLE
Preoperative computerized tomography screening for COVID‑19 pneumonia in asymptomatic patients: experiences from two centers Terman Gümüs1 · Zeynep Unal Kabaoglu2 · Bilgen Coskun2 · Furkan Kartal1 · Feyzi Artukoglu3 · Kayhan Cetin Atasoy1 Received: 5 August 2020 / Accepted: 16 October 2020 © Japan Radiological Society 2020
Abstract Purpose The aim of this retrospective study is to evaluate the preoperative screening performance of chest CT (computerized tomography) examination to detect COVID-19 positive individuals. Materials and methods In this retrospective study 218 adult patients who had preoperative chest CT and RT-PCR were enrolled. CT imaging results, which have been reported according to the Radiological Society of North America expert consensus on COVID-19, were collected from the picture archiving and communicating system. Demographic data, planned surgeries, and postoperative outcomes were collected from the electronic patient records. Results One patient (0.5%) showed typical CT features for COVID-19 pneumonia; 12 patients (5.5%) were reported as indeterminate, and eight (3.7%) were reported as atypical for COVID-19 pneumonia. Only one of the three patients with positive RT-PCR had abnormalities on CT. When RT-PCR tests were taken as reference, the sensitivity, specificity, and accuracy of chest CT in showing COVID-19 infection in asymptomatic patients were 33.3%, 90.7%, and 90.0%, respectively. Conclusion Chest CT screening for COVID-19 has a very low yield in asymptomatic preoperative patients and shows falsepositive findings in 9.2% of cases, potentially leading to unnecessary postponing of the surgery. Keywords COVID-19 · Chest CT · Screening
Introduction Since the first case reported in China on December 31, 2019, COVID-19 pandemic has rapidly spread worldwide, resulting in more than 10 million of confirmed cases and half million deaths in < 6 months [1, 2]. Healthcare workers are most vulnerable; indeed, up to 20% of responding health care providers were reported to be infected [3]. Although the final diagnosis rests with reverse-transcriptase polymerase chain reaction (RT-PCR), this test has several shortcomings including limited availability, relatively long turnaround times, and a low sensitivity varying between 56 and 83% [4]. * Terman Gümüs [email protected] 1
Department of Radiology, University of Koc School of Medicine, Davutpaşa Caddesi No. 4, Topkapı, 34010 Istanbul, Turkey
2
Radiology Department, American Hospital, Istanbul, Turkey
3
Anesthesiology and Reanimation Department, American Hospital, Istanbul, Turkey
Patients with COVID-19 disease who undergo surgery suffer a complicated postoperative course [5, 6]. Studies have shown that up to 51.2% of these patients had pulmonary complications and among patients who had pulmonary complications after surgery 30-day mortality rate was 38% [7]. Also, these patients increase the risk of disease transmission to other patients in the hospital and health care personnel [8]. Aforementioned diagnostic diff
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