Low-dose chest CT for preoperative screening for SARS-CoV-2 infection

Area of Science:

• Medical Imaging
• Infectious Diseases
• Surgical Procedures

Background:

• The COVID-19 pandemic necessitated robust screening protocols for SARS-CoV-2.
• Preoperative screening of asymptomatic surgical patients is crucial to prevent intraoperative transmission.

Purpose of the Study:

• To assess the added value of low-dose chest computed tomography (CT) in complementing reverse transcription polymerase chain reaction (RT-PCR) and health questionnaires for SARS-CoV-2 screening in asymptomatic patients undergoing elective surgery.

Main Methods:

• A prospective study involving 464 asymptomatic patients scheduled for elective surgery.
• Patients underwent a triple screening: health questionnaire, RT-PCR, and low-dose chest CT within 48 hours of surgery.
• SARS-CoV-2 infection was diagnosed by positive RT-PCR and/or CT findings (CO-RADS 4/5).

Main Results:

• No patients reported symptoms or had positive RT-PCR results.
• Only 4.7% of patients (22/464) showed signs compatible with lung infection on chest CT.
• Of these, 20 had indeterminate findings (CO-RADS 2/3), and 2 had findings consistent with resolved COVID-19 pneumonia (CO-RADS 2/3). No SARS-CoV-2 infections were confirmed postoperatively.

Conclusions:

• Low-dose chest CT provided no additional benefit over RT-PCR and health questionnaires for preoperative SARS-CoV-2 screening in this cohort of asymptomatic patients.
• Standard screening methods appear adequate for identifying SARS-CoV-2 in asymptomatic surgical candidates.