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

Carl A J Puylaert; Jochem C G Scheijmans; Alexander B J Borgstein; Caroline S Andeweg; Annemarieke Bartels-Rutten; Geerard L Beets; Mark I van Berge Henegouwen; Sicco J Braak; Roy Couvreur; Freek Daams; Hendrik W van Es; Lotte C Franken; Brechtje A Grotenhuis; Eduard R Hendriks; Ignace H J T de Hingh; Fieke Hoeijmakers; Joris T Ten Holder; Peter M Huisman; Geert Kazemier; Floortje van Kesteren; Jurre van Kesteren; Kammy Keywani; Sara Z Kuiper; Maurits D J Lange; Mark E Lobatto; Arthur W F du Mée; Martijn Poeze; Elise M van Praag; Jorit van Rossen; Hjalmar C van Santvoort; Wouter J A Sedee; Leonard W F Seelen; Sarah Sharabiany; Nico L Sosef; Marian J R Quanjel; Jeroen Veltman; Tim Verhagen; Vincent C J van de Vlasakker; Pepijn D Weeder; Jochem R van Werven; Nina J Wesdorp; Susan van Dieren; Alvin X Han; Colin A Russell; Menno D de Jong; Patrick M M Bossuyt; Jet M E Quarles van Ufford; Mathias W Prokop; Suzanne S Gisbertz; Jan M Prins

doi:10.1097/SLA.0000000000004218

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

Carl A J Puylaert
, Jochem C G Scheijmans
, Alexander B J Borgstein
, Caroline S Andeweg
, Annemarieke Bartels-Rutten
, Geerard L Beets
, Mark I van Berge Henegouwen
, Sicco J Braak
, Roy Couvreur
, Freek Daams
, Hendrik W van Es
, Lotte C Franken
, Brechtje A Grotenhuis
, Eduard R Hendriks
, Ignace H J T de Hingh
, Fieke Hoeijmakers
, Joris T Ten Holder
, Peter M Huisman
, Geert Kazemier
, Floortje van Kesteren

Jurre van Kesteren, Kammy Keywani, Sara Z Kuiper, Maurits D J Lange, Mark E Lobatto, Arthur W F du Mée, Martijn Poeze, Elise M van Praag, Jorit van Rossen, Hjalmar C van Santvoort, Wouter J A Sedee, Leonard W F Seelen, Sarah Sharabiany, Nico L Sosef, Marian J R Quanjel, Jeroen Veltman, Tim Verhagen, Vincent C J van de Vlasakker, Pepijn D Weeder, Jochem R van Werven, Nina J Wesdorp, Susan van Dieren, Alvin X Han, Colin A Russell, Menno D de Jong, Patrick M M Bossuyt, Jet M E Quarles van Ufford, Mathias W Prokop, Suzanne S Gisbertz, Jan M Prins,

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.

SUMMARY OF 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 anesthesia.

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% confidence interval (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.

Original language	English
Pages (from-to)	919-924
Number of pages	6
Journal	Annals of Surgery
Volume	272
Issue number	6
DOIs	https://doi.org/10.1097/SLA.0000000000004218
Publication status	Published - 1 Dec 2020

Keywords

COVID-19
Computed tomography
Preoperative screening
RTPCR

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Yield_of_Screening_for_COVID_19_in_Asymptomatic.11Final published version, 276 KBLicence: Taverne

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Puylaert, C. A. J., Scheijmans, J. C. G., Borgstein, A. B. J., Andeweg, C. S., Bartels-Rutten, A., Beets, G. L., van Berge Henegouwen, M. I., Braak, S. J., Couvreur, R., Daams, F., van Es, H. W., Franken, L. C., Grotenhuis, B. A., Hendriks, E. R., de Hingh, I. H. J. T., Hoeijmakers, F., Ten Holder, J. T., Huisman, P. M., Kazemier, G. (2020). Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study. Annals of Surgery, 272(6), 919-924. https://doi.org/10.1097/SLA.0000000000004218

@article{df39f9c5149641dbad4bc15994876dda,

title = "Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study",

abstract = "OBJECTIVE: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.SUMMARY OF 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 anesthesia.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\% confidence interval (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.",

keywords = "COVID-19, Computed tomography, Preoperative screening, RTPCR",

author = "Puylaert, \{Carl A J\} and Scheijmans, \{Jochem C G\} and Borgstein, \{Alexander B J\} and Andeweg, \{Caroline S\} and Annemarieke Bartels-Rutten and Beets, \{Geerard L\} and \{van Berge Henegouwen\}, \{Mark I\} and Braak, \{Sicco J\} and Roy Couvreur and Freek Daams and \{van Es\}, \{Hendrik W\} and Franken, \{Lotte C\} and Grotenhuis, \{Brechtje A\} and Hendriks, \{Eduard R\} and \{de Hingh\}, \{Ignace H J T\} and Fieke Hoeijmakers and \{Ten Holder\}, \{Joris T\} and Huisman, \{Peter M\} and Geert Kazemier and \{van Kesteren\}, Floortje and \{van Kesteren\}, Jurre and Kammy Keywani and Kuiper, \{Sara Z\} and Lange, \{Maurits D J\} and Lobatto, \{Mark E\} and \{du M{\'e}e\}, \{Arthur W F\} and Martijn Poeze and \{van Praag\}, \{Elise M\} and \{van Rossen\}, Jorit and \{van Santvoort\}, \{Hjalmar C\} and Sedee, \{Wouter J A\} and Seelen, \{Leonard W F\} and Sarah Sharabiany and Sosef, \{Nico L\} and Quanjel, \{Marian J R\} and Jeroen Veltman and Tim Verhagen and \{van de Vlasakker\}, \{Vincent C J\} and Weeder, \{Pepijn D\} and \{van Werven\}, \{Jochem R\} and Wesdorp, \{Nina J\} and \{van Dieren\}, Susan and Han, \{Alvin X\} and Russell, \{Colin A\} and \{de Jong\}, \{Menno D\} and Bossuyt, \{Patrick M M\} and \{Quarles van Ufford\}, \{Jet M E\} and Prokop, \{Mathias W\} and Gisbertz, \{Suzanne S\} and Prins, \{Jan M\}",

year = "2020",

month = dec,

day = "1",

doi = "10.1097/SLA.0000000000004218",

language = "English",

volume = "272",

pages = "919--924",

journal = "Annals of Surgery",

issn = "0003-4932",

publisher = "Wolters Kluwer Health",

number = "6",

}

Puylaert, CAJ, Scheijmans, JCG, Borgstein, ABJ, Andeweg, CS, Bartels-Rutten, A, Beets, GL, van Berge Henegouwen, MI, Braak, SJ, Couvreur, R, Daams, F, van Es, HW, Franken, LC, Grotenhuis, BA, Hendriks, ER, de Hingh, IHJT, Hoeijmakers, F, Ten Holder, JT, Huisman, PM, Kazemier, G, van Kesteren, F, van Kesteren, J, Keywani, K, Kuiper, SZ, Lange, MDJ, Lobatto, ME, du Mée, AWF, Poeze, M, van Praag, EM, van Rossen, J, van Santvoort, HC, Sedee, WJA, Seelen, LWF, Sharabiany, S, Sosef, NL, Quanjel, MJR, Veltman, J, Verhagen, T, van de Vlasakker, VCJ, Weeder, PD, van Werven, JR, Wesdorp, NJ, van Dieren, S, Han, AX, Russell, CA, de Jong, MD, Bossuyt, PMM, Quarles van Ufford, JME, Prokop, MW, Gisbertz, SS, Prins, JM 2020, 'Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study', Annals of Surgery, vol. 272, no. 6, pp. 919-924. https://doi.org/10.1097/SLA.0000000000004218

Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT): Multicenter Study. / Puylaert, Carl A J; Scheijmans, Jochem C G; Borgstein, Alexander B J et al.
In: Annals of Surgery, Vol. 272, No. 6, 01.12.2020, p. 919-924.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Yield of Screening for COVID-19 in Asymptomatic Patients Before Elective or Emergency Surgery Using Chest CT and RT-PCR (SCOUT)

T2 - Multicenter Study

AU - Puylaert, Carl A J

AU - Scheijmans, Jochem C G

AU - Borgstein, Alexander B J

AU - Andeweg, Caroline S

AU - Bartels-Rutten, Annemarieke

AU - Beets, Geerard L

AU - van Berge Henegouwen, Mark I

AU - Braak, Sicco J

AU - Couvreur, Roy

AU - Daams, Freek

AU - van Es, Hendrik W

AU - Franken, Lotte C

AU - Grotenhuis, Brechtje A

AU - Hendriks, Eduard R

AU - de Hingh, Ignace H J T

AU - Hoeijmakers, Fieke

AU - Ten Holder, Joris T

AU - Huisman, Peter M

AU - Kazemier, Geert

AU - van Kesteren, Floortje

AU - van Kesteren, Jurre

AU - Keywani, Kammy

AU - Kuiper, Sara Z

AU - Lange, Maurits D J

AU - Lobatto, Mark E

AU - du Mée, Arthur W F

AU - Poeze, Martijn

AU - van Praag, Elise M

AU - van Rossen, Jorit

AU - van Santvoort, Hjalmar C

AU - Sedee, Wouter J A

AU - Seelen, Leonard W F

AU - Sharabiany, Sarah

AU - Sosef, Nico L

AU - Quanjel, Marian J R

AU - Veltman, Jeroen

AU - Verhagen, Tim

AU - van de Vlasakker, Vincent C J

AU - Weeder, Pepijn D

AU - van Werven, Jochem R

AU - Wesdorp, Nina J

AU - van Dieren, Susan

AU - Han, Alvin X

AU - Russell, Colin A

AU - de Jong, Menno D

AU - Bossuyt, Patrick M M

AU - Quarles van Ufford, Jet M E

AU - Prokop, Mathias W

AU - Gisbertz, Suzanne S

AU - Prins, Jan M

PY - 2020/12/1

Y1 - 2020/12/1

N2 - OBJECTIVE: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.SUMMARY OF 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 anesthesia.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% confidence interval (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.

AB - OBJECTIVE: To determine the yield of preoperative screening for COVID-19 with chest CT and RT-PCR in patients without COVID-19 symptoms.SUMMARY OF 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 anesthesia.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% confidence interval (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.

KW - COVID-19

KW - Computed tomography

KW - Preoperative screening

KW - RTPCR

UR - https://www.scopus.com/pages/publications/85096152143

U2 - 10.1097/SLA.0000000000004218

DO - 10.1097/SLA.0000000000004218

M3 - Article

C2 - 33021367

SN - 0003-4932

VL - 272

SP - 919

EP - 924

JO - Annals of Surgery

JF - Annals of Surgery

IS - 6

ER -

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

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Keywords

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