A B J Borgstein1, J C G Scheijmans, C A J Puylaert, K Keywani, M E Lobatto, R G Orsini, T van Rees Veillinga, J van Rossen, M J Scheerder, R P Voermans, A X Han, C A Russell, J M Prins, H A Gietema, J Stoker, M A Boermeester, S S Gisbertz, M G Besselink. 1. Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, the Netherlands Department of Radiology, Spaarne Gasthuis, Haarlem and Hoofddorp, the Netherlands Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands Department of Radiology, Haaglanden Medical Center, Den Haag, the Netherlands Department of Radiology, Hospital Group Twente, Almelo, the Netherlands Department of Gastroenterology & Hepatology, Amsterdam UMC, University of Amsterdam, the Netherlands Laboratory of Applied Evolutionary Biology, Amsterdam UMC, University of Amsterdam, the Netherlands Department of Internal Medicine, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, the Netherlands Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, the Netherlands.
Abstract
OBTECTIVE: To determine the incremental yield of standardized addition of chest CT to abdominal CT to detect COVID-19 in patients presenting with primarily acute gastrointestinal symptoms requiring abdominal imaging. SUMMARY BACKGROUND DATA: Around 20% of patients with COVID-19 present with gastrointestinal symptoms. COVID-19 might be neglected in these patients, as the focus could be on finding abdominal pathology. During the COVID-19 pandemic several centers have routinely added chest CT to abdominal CT to detect possible COVID-19 in patients presenting with gastrointestinal symptoms. However, the incremental yield of this strategy is unknown. METHODS: This multicenter study in six Dutch centers included consecutive adult patients presenting with acute non-traumatic gastrointestinal symptoms, who underwent standardized combined abdominal and chest CT between March 15, 2020 and April 30, 2020. All CT scans were read for signs of COVID-19 related pulmonary sequelae using the CO-RADS score. The primary outcome was the yield of high COVID-19 suspicion (CO-RADS 4-5) based on chest CT. RESULTS: A total of 392 patients were included. Radiologic suspicion for COVID-19 (CO-RADS 4-5) was present in 17 (4.3%) patients, eleven of which were diagnosed with COVID-19. Only five patients with CO-RADS 4-5 presented without any respiratory symptoms and were diagnosed with COVID-19. No relation with community prevalence could be detected. CONCLUSION: The yield of adding chest CT to abdominal CT to detect COVID-19 in patients presenting with acute gastrointestinal symptoms is extremely low with an additional detection rate of around 1%.
OBTECTIVE: To determine the incremental yield of standardized addition of chest CT to abdominal CT to detect COVID-19 in patients presenting with primarily acute gastrointestinal symptoms requiring abdominal imaging. SUMMARY BACKGROUND DATA: Around 20% of patients with COVID-19 present with gastrointestinal symptoms. COVID-19 might be neglected in these patients, as the focus could be on finding abdominal pathology. During the COVID-19 pandemic several centers have routinely added chest CT to abdominal CT to detect possible COVID-19 in patients presenting with gastrointestinal symptoms. However, the incremental yield of this strategy is unknown. METHODS: This multicenter study in six Dutch centers included consecutive adult patients presenting with acute non-traumatic gastrointestinal symptoms, who underwent standardized combined abdominal and chest CT between March 15, 2020 and April 30, 2020. All CT scans were read for signs of COVID-19 related pulmonary sequelae using the CO-RADS score. The primary outcome was the yield of high COVID-19 suspicion (CO-RADS 4-5) based on chest CT. RESULTS: A total of 392 patients were included. Radiologic suspicion for COVID-19 (CO-RADS 4-5) was present in 17 (4.3%) patients, eleven of which were diagnosed with COVID-19. Only five patients with CO-RADS 4-5 presented without any respiratory symptoms and were diagnosed with COVID-19. No relation with community prevalence could be detected. CONCLUSION: The yield of adding chest CT to abdominal CT to detect COVID-19 in patients presenting with acute gastrointestinal symptoms is extremely low with an additional detection rate of around 1%.