What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure
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ORIGINAL SCIENTIFIC REPORT
What is the Preferred Screening Tool for COVID-19 in Asymptomatic Patients Undergoing a Surgical or Diagnostic Procedure? E. M. Huybens1 • M. P. A. Bus1 • R. A. Massaad1 • L. Wijers2 • J. A. van der Voet2 • N. M. Delfos3 M. van der Feltz3 • K. A. Heemstra4 • S. M. P. Koch1
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Accepted: 18 July 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Introduction Since the outbreak of COVID-19, measures were taken to protect healthcare staff from infection, to prevent infection of patients admitted to the hospital and to distribute PPE according to need. To assure the proper protection without overuse of limited supply of these equipments, screening of patients before surgical or diagnostic procedure was implemented. This study evaluates the results of this screening. Method All patients screened for COVID-19 before procedure warranting either general, locoregional anaesthesia or sedation were included. Screening included a symptom questionnaire by phone, PCR and HRCT chest testing. Surgical or procedural details were registered together with actions taken based on screening results. Results Three hundred ninety-eight screenings were performed on 386 patients. The symptom questionnaire was completed in 72% of screenings. In 371 screenings, PCR testing was performed and negative. HRCT chest found 18 cases where COVID-19 could not be excluded, with negative PCR testing. Three patients had their surgery postponed due to inconclusive screening, and additional measures were taken in three other patients. There were incidental findings in 14% of HRCT chest scans. Discussion Pre-operative screening will differentiate if PPE is needed for procedures and which patients can safely have elective surgery during this COVID-19 pandemic and in the times to come. HRCT chest has no additional value in the pre-operative screening of asymptomatic patients. Screening can be performed with a symptom questionnaire, and additional screening with PCR testing in high-risk patient groups should be considered.
Introduction
& S. M. P. Koch [email protected] 1
Department of General Surgery, Alrijne Hospital, Simon Smitweg 1, 2353, GA, Leiderdorp, The Netherlands
2
Department of Radiology, Alrijne Hospital, Leiderdorp, The Netherlands
3
Department of Infectious Diseases, Alrijne Hospital, Leiderdorp, The Netherlands
4
Department of Microbiology, Alrijne Hospital, Leiderdorp, The Netherlands
Between 31 December 2019 and 3 January 2020, the World Health Organization (WHO) China Country Office was notified of 44 cases of pneumonia with unknown cause in the city of Wuhan, China [1]. Since then, up until 1 July 2020, 10 450 628 cases have been confirmed and 510 632 patients have lost their lives to the virus, now named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) [2]. The first COVID-19 positive test in the Netherlands was confirmed in 27 February 2020. To combat the growing number of patients suffering from COVID-19 and to ensure patient and healt
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