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Evaluation of CT chest as a screening tool for COVID-19 in surgical patients presenting to the Royal Victoria hospital emergency department 1st March-22nd May 2020
EP34257
Poster Title: Evaluation of CT chest as a screening tool for COVID-19 in surgical patients presenting to the Royal Victoria hospital emergency department 1st March-22nd May 2020
Submitted on 27 Oct 2020
Author(s): Katherine O'Boyle, Grainne Culleton, Wendy Coalter, Anton Collins
Affiliations: Belfast Trust
This poster was presented at BIR Annual Congress 2020
Poster Views: 574
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Poster Information
Abstract: AIM: To evaluate the use of additional computed tomography (CT) chest screening for COVID-19 in acute surgical patients presenting to an emergency department in a tertiary centre over a three month time frame.
MATERIALS AND METHODS: Retrospective study of consecutive patients (n=100) who underwent CT chest as part of the acute abdominal pain COVID-19 imaging pathway in the Royal Victoria Hospital emergency department between 1st March and 22nd May 2020. The CT findings were graded using BTSI guidelines as normal, other/non-COVID-19 pathology, indeterminate, or classical COVID-19. Findings were correlated with clinical features and reverse transcription polymerase chain reaction (RT-PCR) results.
RESULTS: Three patients had CT chest findings which were indeterminate for COVID-19, all of which were negative on RT-PCR testing. No patient had classic COVID-19 changes. Nineteen CT scans demonstrated other pathology and 78 were entirely normal. One patient had a positive RT-PCR result; of note this patient’s CT was normal. CT chest findings did not alter the surgical management of any patient.
CONCLUSION: The implementation of additional CT chest did not change surgical management in the acute setting and its use is unjustified given the increased risk of exposure to oncogenic radiation.

Key words COVID-19, surgical, CT, chest, emergency
Summary: Evaluation of the addition of CT chest screening for COVID-19 in surgical patients as part of the acute abdominal pain pathway. References: Inui S, Fujikawa A, Jitsu M, et al. Chest CT Findings in Cases from the Cruise Ship “Diamond Princess” with Coronavirus Disease 2019 (COVID-19) . Radiology: Cardiothoracic Imaging . 2020 Mar 17. ; 2 ( 2 ): e200110 
 https://www.bsgar.org/media/forum/BSGAR_BSTI_joint_decision_tool_for_CT_v1_FINAL_25.03.20.pdf
https://www.rcsed.ac.uk/news-public-affairs/news/2020/march/intercollegiate-general-surgery-guidance-on-covid-19-update
https://www.bsti.org.uk/media/resources/files/BSTI_COVID_CT_Proforma_v2_13.04.2020.pdf
Hare SS, Rodrigues JCL, Nair A, et al. The continuing evolution of COVID-19 imaging pathways in the UK: a British Society of Thoracic Imaging expert reference group update. Clin Radiol. 2020;75(6):399-404.
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