Preoperative computerized tomography screening for COVID-19 pneumonia in asymptomatic patients: experiences from two centers

Jpn J Radiol. 2021 Mar;39(3):240-245. doi: 10.1007/s11604-020-01061-w. Epub 2020 Oct 31.

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 false-positive findings in 9.2% of cases, potentially leading to unnecessary postponing of the surgery.

Keywords: COVID-19; Chest CT; Screening.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / diagnostic imaging*
  • COVID-19 Testing / methods*
  • Female
  • Humans
  • Lung / diagnostic imaging*
  • Male
  • Middle Aged
  • Preoperative Care / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • SARS-CoV-2
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*
  • Turkey
  • Young Adult