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. 2022 Mar 18;27(1):41.
doi: 10.1186/s40001-022-00672-5.

Pre-endoscopy SARS-CoV-2 testing strategy during COVID-19 pandemic: the care must go on

M Casper  1 , M C Reichert  2 , J Rissland  3 , S Smola  3 , F Lammert  2   4 , M Krawczyk  2   5
Affiliations

Pre-endoscopy SARS-CoV-2 testing strategy during COVID-19 pandemic: the care must go on

M Casper et al. Eur J Med Res. .

Abstract

Background: In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions.

Methods: Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021.

Results: Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021.

Conclusion: A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.

Keywords: COVID-19 diagnostic testing; Gastrointestinal diseases; Gastrointestinal endoscopy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Endoscopies performed in 2021. The 7-day incidence rate for the first day of every month is shown in A. Number of endoscopies carried out by month and type of procedure are shown in B. EGD esophagogastroduodenoscopy, ERCP endoscopic retrograde cholangiopancreatography, EUS endoscopic ultrasound
See this image and copyright information in PMC

References

    1. Castro Filho EC, Castro R, Fernandes FF, et al. Gastrointestinal endoscopy during the COVID-19 pandemic: an updated review of guidelines and statements from international and national nocieties. Gastrointest Endosc. 2020;92:440–445.e6. doi: 10.1016/j.gie.2020.03.3854. - DOI - PMC - PubMed
    1. Parasa S, Reddy N, Faigel DO, et al. Global impact of the COVID-19 pandemic on endoscopy: an international survey of 252 centers from 55 countries. Gastroenterology. 2020;159:1579–1581.e5. doi: 10.1053/j.gastro.2020.06.009. - DOI - PMC - PubMed
    1. Lohse S, Pfuhl T, Berkó-Göttel B, Rissland J, Geißler T, Gärtner B, et al. Pooling of samples for testing for SARS-CoV-2 in asymptomatic people. Lancet Infect Dis. 2020;20:1231–1232. doi: 10.1016/S1473-3099(20)30362-5. - DOI - PMC - PubMed
    1. Repici A, Maselli R, Colombo M, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020;92:192–197. doi: 10.1016/j.gie.2020.03.019. - DOI - PMC - PubMed
    1. Casper M, Lepper P, Danziger G, Reichert M, Seiler F, Bals R, Lammert F, Krawczyk M. Gastrointestinal endoscopy during extracorporeal membrane oxygenation (ECMO) for COVID-19. J Gastrointestin Liver Dis. 2020;29(3):471–473. doi: 10.15403/jgld-2826. - DOI - PubMed

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