Disparities in completing testing for SARS-CoV-2 prior to otolaryngology procedures

Objectives: To determine what patient characteristics are associated with completing asymptomatic pre-operative testing for SARS-CoV-2.

Methods: Charts from consecutive patients undergoing ambulatory surgery in otolaryngology at a tertiary care children's hospital from May 4 until May 26, 2020, were reviewed. If two or more siblings were scheduled, only the first sibling was included. Demographics, surgical details, and results of asymptomatic pre-operative testing for SARS-CoV-2 were collected. Patients who completed pre-operative testing were compared with those who did not using logistic regression or Wilcoxon rank-sum tests, α = 0.05.

Results: 216 patients were included. 56.5 % were male, and median age at surgery was 2 years (range 4 months-20 years). 88 patients (40.7 %) had pre-operative SARS-CoV-2 RT-PCR testing. 97.7 % of sampling occurred 2-3 days prior to the procedure, and 98.9 % of results were available within 2 days. The virus was not detected in any cases. In multiple logistic regression, undergoing surgery at the main hospital location rather than a satellite location (OR: 3.13, p = 0.003) and greater median household income for zip (OR: 1.18/$10,000, p = 0.042) were associated with completing pre-operative testing. However, race, insurance type, surgeon, patient age, previous no-show appointments, and household composition did not alter the odds of completing pre-operative testing.

Conclusions: Families were less likely to complete testing if surgery was being performed at a satellite location or if they lived in an area with lesser median household income. This work draws attention to the impact of socioeconomic factors on access to and compliance with pandemic mitigation measures, with important implications for future public health crises.