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

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.

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.