Utility of Preprocedural Testing for SARS-CoV-2

Jun 28, 2021
Font Size
A
A
A
Authors:
Roberts SC, Peaper DR, Sussman LS, Martinello RA, Pettker CM.
Citation:
Utility of Mass SARS-CoV-2 Testing of Asymptomatic Patients Before Ambulatory and Inpatient Preplanned Procedures Requiring Moderate Sedation or General Anesthesia. JAMA Netw Open 2021;4: e2114526.
Summary By:
Salim Hayek, MD, FACC

Quick Takes

  • Systematic preprocedural testing for SARS-CoV-2 aims to decrease health care workers’ exposure and decrease the risk of COVID-19–related periprocedural complications.
  • The proportion of positive tests in asymptomatic individuals undergoing preprocedural testing was 0.4%. Very few patients tested positive after an initial negative test (0.04%).

Study Questions:

What is the number of positive preprocedural tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in asymptomatic patients?

Methods:

This study reports on the number of positive preprocedural SARS-CoV-2 tests in the Yale New Haven Health System, performed from August 1–November 30, 2020 in asymptomatic patients within 3 days of select ambulatory and inpatient procedures (aerosol-generating procedures, or those requiring moderate sedation or general anesthesia).

Results:

A total of 75,528 preprocedure SARS-CoV-2 tests were performed. The median (interquartile range [IQR]) age of participants was 59 (44-69) years and 33,746 (44.7%) were male patients. A total of 318 (0.4%) tested positive. In only 32 cases with 31 patients, preprocedure testing was negative, but a positive result occurred within 7 days. Fourteen of these patients (45.2%) developed symptoms confirming COVID-19. During the evaluation, community SARS-CoV-2 rates ranged between 5 and 179 daily positive tests per 100,000 individuals.

Conclusions:

Mass preprocedural testing may be useful in identifying asymptomatic cases of SARS-CoV-2.

Perspective:

Given the high proportion of asymptomatic SARS-CoV-2 transmission, preprocedural testing for the virus was implemented in health care centers across the world. This is a strategy meant to reduce exposure of health care workers and decrease post-procedural complications in these patients. In this brief report, few patients tested positive, even during times of high community transmission; which may reflect the overall reluctance of many to undergo elective procedures during the pandemic rather than a true surrogate of the burden of infections. An even smaller proportion (0.04%) tested positive after an initial negative test, which reassures that preprocedural testing is an effective strategy to identify asymptomatic infections in that patient population.

Clinical Topics: COVID-19 Hub, Prevention

Keywords: Anesthesia, General, Asymptomatic Infections, Conscious Sedation, Coronavirus, COVID-19, Health Personnel, Inpatients, Mandatory Testing, Primary Prevention, SARS-CoV-2


< Back to Listings