Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients
Objectives Patients with COVID-19 may be asymptomatic and are able to transmit COVID-19 during a surgical procedure, resulting in increased pressure on healthcare and reduced control of COVID-19 spread. There remains uncertainty about the implementation of preoperative screening for COVID-19 in asym...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-07-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/7/e058389.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832576061461757952 |
|---|---|
| author | Menno R Vriens Ellen de Bock Mando D Filipe Milan C Richir Roger K J Simmermacher A Christiaan Kroese |
| author_facet | Menno R Vriens Ellen de Bock Mando D Filipe Milan C Richir Roger K J Simmermacher A Christiaan Kroese |
| author_sort | Menno R Vriens |
| collection | DOAJ |
| description | Objectives Patients with COVID-19 may be asymptomatic and are able to transmit COVID-19 during a surgical procedure, resulting in increased pressure on healthcare and reduced control of COVID-19 spread. There remains uncertainty about the implementation of preoperative screening for COVID-19 in asymptomatic surgical patients. Therefore, this study aims to determine the prevalence of preoperative COVID-19, confirmed by reverse transcriptase PCR (RT-PCR), in asymptomatic patients.Design Systematic review and meta-analysis.Data sources Pubmed and Embase databases were searched through 20 February 2022.Eligibility criteria All COVID-19 articles including preoperative asymptomatic patients were included.Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Meta-analysis was performed to determine the prevalence of COVID-19 with 95% CI. Moreover, estimated positive predictive value (PPV), negative predictive value, false-positives (FP) and false-negatives were calculated for preoperative asymptomatic patients.Results Twenty-seven studies containing 27 256 asymptomatic preoperative screened patients were included, of which 431 were positive for COVID-19 by RT-PCR test. In addition, the meta-analysis revealed a pooled COVID-19 prevalence of 0.76% (95% CI 0.36% to 1.59%). The calculated PPV for this prevalence is 40.8%.Conclusions The pooled COVID-19 prevalence in asymptomatic patients tested preoperatively was 0.76%, with low corresponding PPV. Consequently, nearly three-quarters of postponed surgical procedures in asymptomatic preoperative patients may be FP. In the event of similar pandemics, modification of preoperative mandatory RT-PCR COVID-19 testing in asymptomatic patients may be considered. |
| format | Article |
| id | doaj-art-999c730a1ed04a26b9cc0ad2a8f5b3f6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-999c730a1ed04a26b9cc0ad2a8f5b3f62025-01-31T12:10:10ZengBMJ Publishing GroupBMJ Open2044-60552022-07-0112710.1136/bmjopen-2021-058389Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patientsMenno R Vriens0Ellen de Bock1Mando D Filipe2Milan C Richir3Roger K J Simmermacher4A Christiaan Kroese5Department of Endocrine and Surgical Oncology, Cancer Center, UMC Utrecht, Utrecht, The NetherlandsDepartment of Surgery, Cancer Centre, University Medical Centre, Utrecht, The NetherlandsDepartment of Surgery, Cancer Centre, University Medical Centre, Utrecht, The NetherlandsDepartment of Surgery, Cancer Centre, University Medical Centre, Utrecht, The NetherlandsDepartment of Surgery, University Medical Centre, Utrecht, The NetherlandsDepartment of Anaesthesiology, University Medical Centre, Utrecht, The NetherlandsObjectives Patients with COVID-19 may be asymptomatic and are able to transmit COVID-19 during a surgical procedure, resulting in increased pressure on healthcare and reduced control of COVID-19 spread. There remains uncertainty about the implementation of preoperative screening for COVID-19 in asymptomatic surgical patients. Therefore, this study aims to determine the prevalence of preoperative COVID-19, confirmed by reverse transcriptase PCR (RT-PCR), in asymptomatic patients.Design Systematic review and meta-analysis.Data sources Pubmed and Embase databases were searched through 20 February 2022.Eligibility criteria All COVID-19 articles including preoperative asymptomatic patients were included.Data extraction and synthesis Two independent reviewers extracted data and assessed risk of bias. Meta-analysis was performed to determine the prevalence of COVID-19 with 95% CI. Moreover, estimated positive predictive value (PPV), negative predictive value, false-positives (FP) and false-negatives were calculated for preoperative asymptomatic patients.Results Twenty-seven studies containing 27 256 asymptomatic preoperative screened patients were included, of which 431 were positive for COVID-19 by RT-PCR test. In addition, the meta-analysis revealed a pooled COVID-19 prevalence of 0.76% (95% CI 0.36% to 1.59%). The calculated PPV for this prevalence is 40.8%.Conclusions The pooled COVID-19 prevalence in asymptomatic patients tested preoperatively was 0.76%, with low corresponding PPV. Consequently, nearly three-quarters of postponed surgical procedures in asymptomatic preoperative patients may be FP. In the event of similar pandemics, modification of preoperative mandatory RT-PCR COVID-19 testing in asymptomatic patients may be considered.https://bmjopen.bmj.com/content/12/7/e058389.full |
| spellingShingle | Menno R Vriens Ellen de Bock Mando D Filipe Milan C Richir Roger K J Simmermacher A Christiaan Kroese Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients BMJ Open |
| title | Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients |
| title_full | Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients |
| title_fullStr | Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients |
| title_full_unstemmed | Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients |
| title_short | Meta-analysis of COVID-19 prevalence during preoperative COVID-19 screening in asymptomatic patients |
| title_sort | meta analysis of covid 19 prevalence during preoperative covid 19 screening in asymptomatic patients |
| url | https://bmjopen.bmj.com/content/12/7/e058389.full |
| work_keys_str_mv | AT mennorvriens metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients AT ellendebock metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients AT mandodfilipe metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients AT milancrichir metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients AT rogerkjsimmermacher metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients AT achristiaankroese metaanalysisofcovid19prevalenceduringpreoperativecovid19screeninginasymptomaticpatients |