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Chest tomography for COVID-19 screening in head and neck cancer elective surgery. Is it enough?
Leonardo A Barba-Valadez1, José F Gallegos-Hernández1, Ariadna L Benítez-Martínez1
1Oncology Hospital, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Introduction:
Head and neck cancer patients are at high risk of SARS-CoV-2 infection; surgery in them involves risk for patients, surgeons, health personnel, medical institutions and society, since it is associated with prolonged and inadvertent production of aerosols and emergency procedures that facilitate the breach of protective measures by health personnel.
Objective:
To find out if pulmonary tomographic findings are sufficient to preoperatively identify patients with COVID-19.
Methods:
Retrospective, cross-sectional, analytical study of patients with cervical-facial neoplasms who were candidates for surgery, preoperatively evaluated by simple chest computed tomography based on the CO-RADS classification. In CO-RADS ≥ 3 patients, surgery was suspended and PCR was performed using nasopharyngeal swab.
Results:
322 patients were included, all without COVID-19 symptoms. Tomography was positive in 35 (10.87%); in 30, nasopharyngeal swab was performed: 28 were negative and two were positive; none developed COVID-19 symptoms.
Conclusions:
Chest tomography is not useful as the only preoperative screening procedure for COVID-19, since its findings are nonspecific, with a high rate of false-positive results. Clinical evaluation, with PCR and tomography, is the best form of preoperative screening.
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