Coronavirus Disease Transmission Prevented in an Endoscopy Unit with Universal Protective Measures and No Systematic Preprocedural Testing

Abstract

Background and aims: Even after two years of pandemic, there are still uncertainties on how to proceed when we schedule endoscopic procedures. During the COVID-19 pandemic, some scientific societies recommended universal preprocedural testing for all patients. However, other societies recommended against and considered enough to maintain strict infection control strategies. Our aim was to evaluate this approach in order to see if it was safe for both patients and healthcare workers to proceed with the endoscopies without performing a systematic PCR on all patients. Methods: Retrospective chart review of all patients undergoing endoscopy without preprocedural COVID testing at our center from March 2020 to May 2021. PCR tests performed in the patients receiving an endoscopic procedure were analyzed, and patients who tested positive between 14 days before and after the endoscopic procedure were selected. The registry of the endoscopy unit members participating in these procedures was also analyzed. Results: A total of 10,132 procedures were performed in the unit with 26 patients infected with SARS-CoV-2. Nineteen of these procedures were performed in patients with unknown SARS-CoV-2 carrier status. In 23 (88.5%) cases, transmission occurred through social or familial contact, and in 3 (11.5%), transmission occurred in the hospital. Four health care workers became infected during this period and none of them were related to the endoscopic procedures performed in patients with COVID-19. Conclusions: SARS-CoV-2 positive testing in asymptomatic ambulatory patients is rare and the adequate use of individual protective measures emerges as the main way to control the spread of COVID-19 infection in endoscopy centers.

Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

“…In contrast to this study, we did not observe a rapid catch up in the number of CRC cases diagnosed. There are several reasons for this: the unequal restart of CRC screening in the different Spanish regions; the reluctance of patients to participate in these screening programs after a positive FIT result; further challenges faced by endoscopy services in increasing capacity back to prepandemic levels, such as staff absences, infection control measures and additional administrative burden such as telephone triaging and preprocedural SARS‐CoV‐2 testing 28 . These situations can conduct an inequities on the resumption of screening.…”

“…There are several reasons for this: the unequal restart of CRC screening in the different Spanish regions; the reluctance of patients to participate in these screening programs after a positive FIT result; further challenges faced by endoscopy services in increasing capacity back to prepandemic levels, such as staff absences, infection control measures and additional administrative burden such as telephone triaging and preprocedural SARS-CoV-2 testing. 28 These situations can conduct an inequities on the resumption of screening. Some studies have suggested that the COVID-19 pandemic can have an uneven effect on CRC outcomes depending on whether and how fast screening is resumed after the pandemic onset.…”

Universal admission laboratory screening for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) asymptomatic infection across a large health system

“…benefits of such testing is unclear, particularly with the use of other hierarchies of control to prevent the spread of SARS-CoV-2, such as the universal use of face masks, visitor restrictions, environmental cleaning, and vaccination. 3 Prior studies examining the impact of universal laboratory admission screening for SARS-CoV-2 infection are limited (1) by short study periods (ie, weeks to a few months) that occurred early in the COVID-19 pandemic, (2) by study in single hospital settings, and (3) by assessment during periods of low COVID-19 community incidence. [4][5][6][7][8][9][10] As COVID-19 activity continues to wax and wane, it is important to evaluate the experience of admission screening programs.…”