Yield of Adding chest CT to Abdominal CT to Detect COVID-19 in Patients Presenting with Acute Gastrointestinal Symptoms (SCOUT-3): Multicenter Study.

Obtective To determine the incremental yield of standardized addition of chest CT to abdominal CT to detect COVID-19 in patients presenting with primarily acute gastrointestinal symptoms requiring abdominal imaging. Summary background data Around 20% of patients with COVID-19 present with gastrointestinal symptoms. COVID-19 might be neglected in these patients, as the focus could be on finding abdominal pathology. During the COVID-19 pandemic several centers have routinely added chest CT to abdominal CT to detect possible COVID-19 in patients presenting with gastrointestinal symptoms. However, the incremental yield of this strategy is unknown. Methods This multicenter study in six Dutch centers included consecutive adult patients presenting with acute non-traumatic gastrointestinal symptoms, who underwent standardized combined abdominal and chest CT between March 15, 2020 and April 30, 2020. All CT scans were read for signs of COVID-19 related pulmonary sequelae using the CO-RADS score. The primary outcome was the yield of high COVID-19 suspicion (CO-RADS 4-5) based on chest CT. Results A total of 392 patients were included. Radiologic suspicion for COVID-19 (CO-RADS 4-5) was present in 17 (4.3%) patients, eleven of which were diagnosed with COVID-19. Only five patients with CO-RADS 4-5 presented without any respiratory symptoms and were diagnosed with COVID-19. No relation with community prevalence could be detected. Conclusion The yield of adding chest CT to abdominal CT to detect COVID-19 in patients presenting with acute gastrointestinal symptoms is extremely low with an additional detection rate of around 1%.