Negative preoperative RT-PCR screening is no guaranty of no SARS-CoV-2 infection

Lippi, G.; Sanchis-Gomar, F.; Henry, B.M.

doi:10.1016/j.redare.2021.06.007

array:24 ["pii" => "S2341192923000197" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.06.007" "estado" => "S300" "fechaPublicacion" => "2023-02-01" "aid" => "1368" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2023;70:119-20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935621002206" "issn" => "00349356" "doi" => "10.1016/j.redar.2021.06.006" "estado" => "S300" "fechaPublicacion" => "2023-02-01" "aid" => "1368" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Rev Esp Anestesiol Reanim. 2023;70:119-20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Carta al Director" "titulo" => "El cribado preoperatorio negativo mediante RT-PCR no garantiza la no infección por SARS-CoV-2" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "119" "paginaFinal" => "120" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Negative preoperative RT-PCR screening is no guaranty of no SARS-CoV-2 infection" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Lippi, F. Sanchis-Gomar, B.M. Henry" "autores" => array:3 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Lippi" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Sanchis-Gomar" ] 2 => array:2 [ "nombre" => "B.M." "apellidos" => "Henry" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192923000197" "doi" => "10.1016/j.redare.2021.06.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192923000197?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935621002206?idApp=UINPBA00004N" "url" => "/00349356/0000007000000002/v1_202301310659/S0034935621002206/v1_202301310659/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192923000227" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.09.013" "estado" => "S300" "fechaPublicacion" => "2023-02-01" "aid" => "1391" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2023;70:121-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Image of the month" "titulo" => "Haemopneumoencephalus as a complication of transsphenoidal approach" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "121" "paginaFinal" => "122" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemoneumoencéfalo como complicación a abordaje transesfenoidal" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 966 "Ancho" => 750 "Tamanyo" => 118569 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Axial cranial CT section of the patient after surgery." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Moreno-Carbonell, J. Magno Serrano, P. De Alonso Andrés, F.P. Bueno Villalba" "autores" => array:4 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Moreno-Carbonell" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Magno Serrano" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "De Alonso Andrés" ] 3 => array:2 [ "nombre" => "F.P." "apellidos" => "Bueno Villalba" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S003493562100270X" "doi" => "10.1016/j.redar.2021.09.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493562100270X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192923000227?idApp=UINPBA00004N" "url" => "/23411929/0000007000000002/v1_202303141745/S2341192923000227/v1_202303141745/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192923000240" "issn" => "23411929" "doi" => "10.1016/j.redare.2021.11.005" "estado" => "S300" "fechaPublicacion" => "2023-02-01" "aid" => "1402" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2023;70:118-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Letter to the Director" "titulo" => "Extracorporeal cardiopulmonary resuscitation in accidental hypothermia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "118" "paginaFinal" => "119" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reanimación cardiopulmonar extracorpórea en hipotermia accidental" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Blasco Mariño, M. Martín Orejas, M.Á. González Posada, Í. Soteras Martinez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Blasco Mariño" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Martín Orejas" ] 2 => array:2 [ "nombre" => "M.Á." "apellidos" => "González Posada" ] 3 => array:2 [ "nombre" => "Í." "apellidos" => "Soteras Martinez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S003493562100298X" "doi" => "10.1016/j.redar.2021.11.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493562100298X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192923000240?idApp=UINPBA00004N" "url" => "/23411929/0000007000000002/v1_202303141745/S2341192923000240/v1_202303141745/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Letter to the Director" "titulo" => "Negative preoperative RT-PCR screening is no guaranty of no SARS-CoV-2 infection" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "119" "paginaFinal" => "120" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "G. Lippi, F. Sanchis-Gomar, B.M. Henry" "autores" => array:3 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Lippi" "email" => array:1 [ 0 => "giuseppe.lippi@univr.it" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Sanchis-Gomar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "B.M." "apellidos" => "Henry" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Section of Clinical Biochemistry, University of Verona, Verona, Italy" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Fisiología, Facultad de Medicina, Universidad de Valencia e INCLIVA Biomedical Research Institute, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "The Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El cribado preoperatorio negativo mediante RT-PCR no garantiza la no infección por SARS-CoV-2" ] ] "textoCompleto" => "We read with interest the article published by De la Matta et al.,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> who concluded that the value of indiscriminate preoperative reverse transcription-polymerase chain reaction (RT-PCR) screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is questionable in identifying asymptomatic carriers. Although this conclusion is based on evidence that none of the 4520 preoperative RT-PCR tests performed at the local level yielded a positive result, several additional aspects should be considered when interpreting negative RT-PCR test results. Firstly, in contradiction to the authors who stated that the diagnostic sensitivity of RT-PCR is up to 95% in diagnosing SARS-CoV-2 infection, lines of evidence confirm that the rate of positive results from a single RT-PCR test by nasopharyngeal swab is around 85%, increasing to more than 95% when the sample is collected and tested a third time.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> An additional source of uncertainty is the high risk of false negative RT-PCR tests during the early stage of SARS-CoV-2 infection (typically 3–5 days after exposure to the virus), which can be as high as 50%.<a class="elsevierStyleCrossRef" href="#bib0015">3</a> Inadequate secretion collection due to poor technique may also mean swabs fail to reach the nasopharynx, thereby increasing false negative rates and underestimating the prevalence of SARS-CoV-2 infection.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> The above factors could result in a significant number of patients being erroneously considered "negative" and subsequently developing active SARS-CoV-2 infection, with a high potential to spread the virus and thus generate in-hospital outbreaks. Finally, the diagnostic yield of molecular tests is considerably lower in presymptomatic/asymptomatic patients than in symptomatic patients, with a decrease in sensitivity from 96% to 70%, thus magnifying the risk of false negative tests in subjects infected with SARS-CoV-2 in the presymptomatic stage or in asymptomatic carriers. Since De la Matta et al. did not undertake any follow-up testing after the initial test, it seems unrealistic to conclude that the proportion of asymptomatic carriers among surgical patients would be "<1/2722", as they claim.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Although we agree that widespread screening for SARS-CoV-2 in asymptomatic populations is unnecessary, and perhaps unwarranted for a variety of social, economic, and diagnostic reasons,<a class="elsevierStyleCrossRef" href="#bib0025">5</a> we disagree with the conclusion that the rate of asymptomatic surgical patients is always negligible in low prevalence scenarios, especially when combined with a highly vulnerable setting. Efficient testing protocols are essential to reduce in-hospital outbreaks and protect the most vulnerable patients (i.e., the immunocompromised and elderly), and may be critical given the rapid spread of new SARS-CoV-2 variants of concern (VOC).Conflict of interestsThe authors have no conflict of interests to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Utility of preoperative polymerase chain reaction testing during SARS-CoV-2 pandemic: the challenge of evolving incidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. De la Matta" 1 => "J.M. Delgado-Sánchez" 2 => "G.M. Gutiérrez" 3 => "J.L. López Romero" 4 => "M.M. Martínez Gómez" 5 => "A. Domínguez Blanco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.redare.2020.10.002" "Revista" => array:2 [ "tituloSerie" => "Rev Esp Anestesiol Reanim (Engl Ed)" "fecha" => "2021" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Distinct characteristics of COVID-19 patients with initial rRT-PCR-positive and rRT-PCR-negative results for SARS-CoV-2" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Zhang" 1 => "Y.Y. Cao" 2 => "X. Dong" 3 => "B.C. Wang" 4 => "M.Y. Liao" 5 => "J. Lin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Allergy" "fecha" => "2020" "volumen" => "75" "paginaInicial" => "1809" "paginaFinal" => "1812" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variation in false-negative rate of reverse transcriptase polymerase chain reaction-based SARS-CoV-2 tests by time since exposure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.M. Kucirka" 1 => "S.A. Lauer" 2 => "O. Laeyendecker" 3 => "D. Boon" 4 => "J. Lessler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/M20-1495" "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2020" "volumen" => "173" "paginaInicial" => "262" "paginaFinal" => "267" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32422057" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of saliva, oropharyngeal swabs, and nasal swabs for SARS-CoV-2 molecular detection: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R.A. Lee" 1 => "J.C. Herigon" 2 => "A. Benedetti" 3 => "N.R. Pollock" 4 => "C.M. Denkinger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/JCM.02881-20" "Revista" => array:6 [ "tituloSerie" => "J Clin Microbiol" "fecha" => "2021" "volumen" => "59" "paginaInicial" => "e02881" "paginaFinal" => "e02920" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33504593" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Potential drawbacks of frequent asymptomatic coronavirus disease 2019 (COVID-19) testing" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Lippi" 1 => "B.M. Henry" 2 => "F. Sanchis-Gomar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1017/ice.2020.1305" "Revista" => array:2 [ "tituloSerie" => "Infect Control Hosp Epidemiol" "fecha" => "2020" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000007000000002/v1_202303141745/S2341192923000197/v1_202303141745/en/main.assets" "Apartado" => array:4 [ "identificador" => "66474" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letter to the Director" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000007000000002/v1_202303141745/S2341192923000197/v1_202303141745/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192923000197?idApp=UINPBA00004N"]

ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

See more Open Access Option

Revista Española de Anestesiología y Reanimación has received its first journal Impact Factor (JCR) in 2023. Instructions for authors - Submit an article

Indexed in:

Web of Science, Emerging Sources Citation Index (WoS, Clarivate), PubMed/Medline, Scopus, EMBASE, IBECS

Subscribe:

Impact factor

The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years.

© Clarivate Analytics, Journal Citation Reports 2022

Impact factor 2023

0.9

Citescore

CiteScore measures average citations received per document published.

Citescore 2023

1.8

SJR

SRJ is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and qualitative measure of the journal's impact.

SJR 2023

0.239

SNIP

SNIP measures contextual citation impact by wighting citations based on the total number of citations in a subject field.

SNIP 2023

362

View more metrics

Journal Information

Previous article | Next article

Vol. 70. Issue 2.

Pages 119-120 (February 2023)

Lee este artículo en Español

Export reference

Download PDF

Article

These are the options to access the full texts of the publication Revista Española de Anestesiología y Reanimación (English Edition)

Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”

Subscribe to

Revista Española de Anestesiología y Reanimación (English Edition)

More information

Purchase

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now

Contact

Phone for subscriptions and reporting of errors

From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.

Calls from Spain

932 415 960

Calls from outside Spain

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

Publish in

Revista Española de Anestesiología y Reanimación

Tools

Revista Española de Anestesiología y Reanimación (English Edition) is a member and subscribes the principles of, the Committee on Publication Ethics (COPE)
www.publicationethics.org.

Free access articles

Management of peri-surgical anemia in elective surgery....

Revista Española de Anestesiología y Reanimación (English Version). 2024;71:454-65

Risk factors for PPCs in laparoscopic non–robotic...

Revista Española de Anestesiología y Reanimación (English Version). 2024;71:592-600

Pre-anaesthesia assessment in cataract surgery:...

Revista Española de Anestesiología y Reanimación (English Version). 2024;71:403-11

Indexed in:

Follow us:

Subscribe:

Article

Subscribe to our newsletter