The Role of CT Chest Scan in the Pre-anesthetic Assessment of Suspected or Confirmed COVID -19 Patients

The Use of Preoperative CT Chest Scan in the Pre-anesthetic Assessment of COVID-19

The role of CT scan of the chest in Pre-anesthetic assessment of the severity of COVID-19 and the correlations between CT measurements of the aortic and pulmonary arteries diameters and severity of pneumonia.

Study Overview

• Status: Completed
• Conditions: Covid19
• Intervention / Treatment: Radiation: Non-enhanced CT scan of the chest

Detailed Description

Patients who were scheduled for emergency surgery during COVID-19 pandemic should have be screened for COVID pre-operatively given the prevalence f asymptomatic or mildly symptomatic cases that could be carriers to infection and possibly cause cross infection to the operating room staff especially the anesthetists who deal with the upper airway during intubation with high possibility of getting infected with SARS-COV 2 virus. Waiting respiratory tract PCR (RT-PCR) test for COVID can delay the surgery which may increase patients morbidity and mortality. RT-PCR test has limited sensitivity and specificity.

Patients who are confirmed to have COVID-19 infection (have positive RT-PCR) or patients who have possible COVID-19 infection (have symptoms but were not tested with RT-PCR) will undergo non-enhanced CT scanning of the chest (without giving IV contrast).

Chest CT scan will be interpreted by 2 Consultants radiologists with an experience of at least 10 years in their field.

The radiologists are going to be requested to comment on the lung parenchyma, describing the findings , assess the pulmonary artery, aorta diameters and the aorta:pulmonary diameters ratio will be then calculated. The degree of pneumonia severity index will then be described as well.

The radiologists will be blinded to the aim of the study.

All data will be collected and then correlation between the data sets will be statistically tested.

• Study Type: Observational
• Enrollment (Actual): 76

Contacts and Locations

Study Locations

• Saudi Arabia
  • Riyadh, Saudi Arabia
    • Security Forces Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients who are older than 18 years, having confirmed or suspected COVID-19 infection and scheduled for emergency surgery.

Description

Inclusion Criteria:

• All patients scheduled for emergency surgery with symptoms suggestive of COVID-19 infection.

Exclusion Criteria:

• Pregnancy.
• Haemodynamic instability (Mean arterial blood pressure above 65 mmHg or the need for of inotropic drugs to maintain mean arterial blood pressure above 65 mmHg).
• Active bleeding.
• Any indication by the surgeon or the anesthesiologist to proceed for immediate surgery for the patient safety.
• Patients refusal to do CT scanning.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pneumonia severity.	The pneumonia severity will be assessed by the radiologist.	90 days
Aorta diameter	Aorta cross sectional diameter will be calculated by using cursor method on CT scan	90 days
Pulmonary artery diameter	Pulmonary artery sectional diameter will be calculated by using cursor method on CT scan	90 days
Pulmonary artery diameter TO Aorta diameter ratio	Pulmonary artery diameter TO Aorta diameter ratio will be calculated	90 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Description of the lesions found in the CT scan	The parenchymal lesions will be described by the radiologist	90 days

Collaborators and Investigators

• Sponsor: Tanta University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2020
• Primary Completion (Actual): July 30, 2020
• Study Completion (Actual): September 1, 2020

Study Registration Dates

• First Submitted: September 22, 2020
• First Submitted That Met QC Criteria: September 22, 2020
• First Posted (Actual): September 23, 2020

Study Record Updates

• Last Update Posted (Actual): September 23, 2020
• Last Update Submitted That Met QC Criteria: September 22, 2020
• Last Verified: September 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; COVID-19
• Other Study ID Numbers: chest CT scan in COVID-19

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No