Investigation of COVID-19 Positive Test Prior to Elective Surgeries Published From MedStar Health Team

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Researchers from MedStar Health Urgent Care/MedStar Ambulatory Services, MedStar Health Research Institute and Georgetown University recently published research to determine what percentage of preoperative asymptomatic patients tested positive for COVID-19 on a hospital-based polymerase chain reaction (PCR) testing platform.  The researchers also sought to determine if there were certain demographics (ie, gender, age) which led to a higher pretest probability of an asymptomatic positive test.   

"Incidence of SARS-CoV-2 in Preoperative Patients Tested in an Urgent Care Setting" was published in the Journal of Urgent Care Medicine. The emergence of COVID brought on unique challenges for healthcare professionals.  It was essential to have the capability to identify patients with COVID-19 before they undergo a surgical procedure to ensure safety to the patient, the surgical team, and postoperative staff. Given the fact that many patients with the virus never exhibit symptoms, proactive preoperative testing in the urgent care center may lower the risk of spread and help quantify the rate of asymptomatic infection.  

As COVID began to spread more rapidly, there was higher demand in healthcare services including availability of healthcare personnel, equipment and hospital beds. To aid in conserving hospital resources and minimize exposure to COVID-19, semi-elective and elective procedures were suspended.  

The research included a total of 1,262 patients scheduled to undergo elective or semi-elective procedure presenting to a MedStar Health Urgent Care facility or urgent care testing tent for a nasopharyngeal (NP) PCR test 1–5 days prior to their scheduled surgery. After testing, patients were advised to quarantine at home to minimize any new exposures to the virus prior to their surgical date.   

The study results show that 29 (2.30%) patients tested positive for COVID-19. Patients between 20-29 years of age had the highest rate of positive cases around 6%. Patients over 80 years old or under 10 years old had no positive cases. However, the difference was not statistically significant. The data collected shows that gender is not a factor in rate of asymptomatic COVID-19 cases. As with age, our study shows that gender is not a factor in rate of asymptomatic COVID-19 cases. While females had a higher rate of positive asymptomatic tests (2.89%) compared with males (1.65%), the difference is not statistically significant.     

The research team concluded the findings from this study support the continued practice of testing for SARS-CoV-2 in all preoperative patients, with a positivity rate of over 2% in asymptomatic patients.
 
Because asymptomatic transmission is an important factor in the spread of the virus, all individuals, regardless of age and gender, should remain diligent to decrease the potential of asymptomatic transmission of the virus. Urgent care providers should take precautions prior to all patient interactions, not just patients with COVID-19 symptoms. Furthermore, these safeguards should be upheld with all patients regardless of gender or age. Additionally, these data suggest there are variables independent of gender and age that influence expression of symptoms of COVID-19.  

Journal of Urgent Care Medicine, 2020. 15(4):33-36

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