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"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" => "<span class="elsevierStyleTextfn">Letter to the Director</span>" "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" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Sanchis-Gomar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "B.M." "apellidos" => "Henry" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "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" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the article published by De la Matta et al.,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></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"><span class="elsevierStyleSup">2</span></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"><span class="elsevierStyleSup">3</span></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"><span class="elsevierStyleSup">4</span></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"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">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"><span class="elsevierStyleSup">5</span></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).</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "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. 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