Symptoms of COVID-19 are rarely found when pre-screening surgical patients for their procedures, according to the findings from a new University of Miami Miller School of Medicine study.
“Pre-procedural testing is intended to protect patients, clinicians and staff from exposure to infectious disease,” said Hayley Gershengorn, M.D., associate professor of pulmonary and critical care medicine. “Screening for symptoms is important, but when the prevalence of COVID-19 in the community is low, other issues come into play, including testing costs and procedural delays from false positive results. Also, some patients with the virus may be asymptomatic.”
Dr. Gershengorn was the lead author of the study, “Pre-Procedural Screening for COVID-19 with Nasopharyngeal Polymerase Chain Reaction Testing,” published recently in the British Journal of Anaesthesia. The UM researchers sought to assess the frequency of positive pre-procedural COVID-19 tests, to identify factors associated with testing positive, and evaluate the need for more than one test.
The study included all 4,176 adult cases scheduled at the University of Miami Hospital and Clinics from April 1 to June 9. During this time, institutional practice was to obtain one or more PCR tests at least 72 hours before procedures. Of those patients, only 19 had at least one positive COVID-19 test within seven days pre-procedure.
“With any novel infectious disease, it is important to be cautious before bringing in patients for surgical procedures,” said Dr. Gershengorn. “But our analysis shows that there is little role for obtaining more than one test pre-procedurally. As we learn more about the incubation period, risk of asymptomatic transmission, and exposure potential of COVID-19, it will be important to reconsider policies advocating for testing every patient pre-procedurally, even once.”
“These findings speak volumes about how quantitative analysis is helping reshape health care operations,” said study co-author Prem R. Warde, M.S.I.E., P.M.P., C.P.A., manager of process improvement and data science at University of Miami Hospital and Clinics. He added that the vision of the UHealth Data Analytics Research Team is to “produce reliable research to support informed leadership decision making.”
Other co-authors of the study were Dao Nguyen, M.D., clinical professor and a cardiothoracic surgery specialist; Maritza Suarez, M.D., an internal medicine specialist; Nipun B. Merchant, M.D., professor of surgery, associate director of translational research, chief surgical officer, and vice chair of surgical oncology services, and director of surgical oncology research; Tanira Ferreira, M.D., chief medical officer of University of Miami Hospital and Clinics; and Bhavarth Shukla, M.D., M.P.H., medical director of infection control for the University of Miami Health System.