Chatzaraki Vasiliki, Kubik-Huch Rahel A, Potempa Anna, Gashi Andi, Friedl Andrée, Heesen Michael, Wiggli Benedikt, Nocito Antonio, Niemann Tilo
Department of Radiology, Kantonsspital Baden, Baden, Switzerland.
Department of Health Sciences and Technology, Swiss Federal Institute of Technology ETH Zurich, Zurich, Switzerland.
J Perioper Pract. 2021 Aug 5:17504589211024405. doi: 10.1177/17504589211024405.
The COVID-19 pandemic challenges the recommendations for patients' preoperative assessment for preventing severe acute respiratory syndrome coronavirus type 2 transmission and COVID-19-associated postoperative complications and morbidities.
To evaluate the contribution of chest computed tomography for preoperatively assessing patients who are not suspected of being infected with COVID-19 at the time of referral.
Candidates for emergency surgery screened via chest computed tomography from 8 to 27 April 2020 were retrospectively evaluated. Computed tomography images were analysed for the presence of COVID-19-associated intrapulmonary changes. When applicable, laboratory and recorded clinical symptoms were extracted.
Eighty-eight patients underwent preoperative chest computed tomography; 24% were rated as moderately suspicious and 11% as highly suspicious on computed tomography. Subsequent reverse transcription polymerase chain reaction (RT-PCR) was performed for seven patients, all of whom tested negative for COVID-19. Seven patients showed COVID-19-associated clinical symptoms, and most were classified as being mildly to moderately severe as per the clinical classification grading system. Only one case was severe. Four cases underwent RT-PCR with negative results.
In a cohort without clinical suspicion of COVID-19 infection upon referral, preoperative computed tomography during the COVID-19 pandemic can yield a high suspicion of infection, even if the patient lacks clinical symptoms and is RT-PCR-negative. No recommendations can be made based on our results but contribute to the debate.
2019冠状病毒病（COVID-19）大流行对患者术前评估的建议提出了挑战，这些建议旨在预防严重急性呼吸综合征冠状病毒2传播以及与COVID-19相关的术后并发症和发病率。
评估胸部计算机断层扫描在术前评估转诊时未怀疑感染COVID-19的患者中的作用。
对2020年4月8日至27日通过胸部计算机断层扫描筛选的急诊手术候选人进行回顾性评估。分析计算机断层扫描图像中是否存在与COVID-19相关的肺部变化。在适用的情况下，提取实验室检查结果和记录的临床症状。
88例患者接受了术前胸部计算机断层扫描；24%在计算机断层扫描中被评为中度可疑，11%为高度可疑。随后对7例患者进行了逆转录聚合酶链反应（RT-PCR），所有患者COVID-19检测均为阴性。7例患者出现与COVID-19相关的临床症状，根据临床分类分级系统，大多数被归类为轻度至中度严重。只有1例为重度。4例患者进行了RT-PCR，结果为阴性。
在转诊时无临床怀疑COVID-19感染的队列中，COVID-19大流行期间的术前计算机断层扫描可能会导致对感染的高度怀疑，即使患者没有临床症状且RT-PCR结果为阴性。根据我们的结果无法提出建议，但有助于引发讨论。
