TUESDAY, Nov. 17, 2020 — Preoperative nasopharyngeal swab testing is beneficial before major surgery and in high severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-risk areas, according to a study published in the British Journal of Surgery.
Members of the COVIDSurg Collaborative at the University of Birmingham in the United Kingdom evaluated the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications for up to 30 days in patients undergoing elective cancer surgery among an international cohort of 8,784 patients (432 hospitals; 53 countries).
The researchers found that 26.2 percent of patients underwent preoperative testing, with 16.6 percent having a swab test, 5.9 percent a computed tomography (CT) scan only, and 3.7 percent a swab test and CT scan. Pulmonary complications occurred in 3.9 percent, while SARS-CoV-2 infection was confirmed in 2.6 percent. Having at least one negative preoperative nasopharyngeal swab test was associated with a lower rate of pulmonary complications in adjusted analyses (adjusted odds ratio, 0.68). Before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, swab testing was beneficial, but not before minor surgery or in low-risk areas. The number needed to swab test before major or minor surgery to prevent one pulmonary complication was 18 and 48, respectively, in high-risk areas, and 73 and 387, respectively, in low-risk areas.
“We urge care providers to provide a routine swab test for all patients undergoing elective surgery whether or not they have symptoms,” collaborative lead Aneel Bhangu, M.B.Ch.B., from the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham, said in a statement.
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