High prevalence of SARS-CoV-2 infection in patients scheduled for digestive endoscopy after the peak of the first wave of the pandemic

Abstract

Healthcare professionals in endoscopy units have a possible risk of SARS-CoV-2 infection by different routes: inhalation of airborne droplets, aerosols, conjunctival contact and faecal-oral transmission. Objective To describe the detection of SARS-CoV-2 in a series of patients scheduled for digestive endoscopy at the Hospital Santa Caterina, Salt, (Girona). Methods Descriptive study of a series of cases of patients scheduled for endoscopy during the month of May 2020, when endoscopic activity was resumed after the peak of the pandemic, following SCD, SEED, AEG and ESGE recommendations. We examined nasopharyngeal samples 48−72 h before the appointment, by RT-PCR, in all patients. RNA extraction was performed using the kits: Qiagen®-adapted, BiosSprint®96-DNA-Blood-Kit (384). For amplification-detection of SARS-CoV-2, methods recommended by the WHO and the CDC were followed. Results 110 asymptomatic patients without close contact with a positive case in the previous 14 days were scheduled; 105 (96.4%) were negative and five (4.5%) were positive. Two patients developed respiratory symptoms after diagnosis (presymptomatic) and three remained asymptomatic. Allfive5 patients were autochthonous cases with no history of travel or residence in another city or country associated with high prevalence of infection. Four cases were women aged 60–81 years. The N gene was detected in all cases. Conclusions A high prevalence of SARS-CoV-2 infection was detected in patients scheduled for digestive endoscopy. Given the risk of transmission to professionals, we consider it advisable to perform SARS-CoV-2 RT-PCR 48−72 h before the examination in situations of high incidence in the population.

Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: update of a living systematic review and meta-analysis

“…Amongst all 130 included studies, 88 studies used more than one method of follow-up to ascertain asymptomatic status (Table 1, S2 Table). Only 22 of 130 studies reported the median or mean age [38,47,70,76,77,83,85,95,99,119-121,124,126,128,133,134,139,143,146,152,164] and only five studies included children only [65,67,110,115,118]. Only 31 studies reported the sex of people with asymptomatic SARS-CoV-2 (Table 1, S2 Table) [38,47,51,53,70,71,75,76,83,85,95,99,107,119-122,124,126,128,133,134,139,143,146,147,150,153,158,162,164].…”

“…Only 22 of 130 studies reported the median or mean age [38,47,70,76,77,83,85,95,99,119-121,124,126,128,133,134,139,143,146,152,164] and only five studies included children only [65,67,110,115,118]. Only 31 studies reported the sex of people with asymptomatic SARS-CoV-2 (Table 1, S2 Table) [38,47,51,53,70,71,75,76,83,85,95,99,107,119-122,124,126,128,133,134,139,143,146,147,150,153,158,162,164]. The types of included studies changed across the five versions of the review.…”

“…In 84 screening studies, the IQR for estimates from individual studies was 20-65% and the prediction interval was 4-94% [41-48,50-54,56,58-63,67,69-71,73,74,79,83,86,88-97,99-101,103-105,107,109,110,114-117,119,120,122,124-126,128,130,133-138,143-145,147,150-156,158-164]. The ranges of estimates were similar in three settings in which screening studies were conducted; people in a community setting (23 studies, IQR 20-53%, prediction interval 2-96%), institutional settings such as nursing homes (43 studies, IQR 26-67%, prediction interval 5-93%), and occupational settings such as amongst groups of healthcare workers (18 studies, IQR 17-64%, prediction interval 3-95%) (S2 Fig).…”

Pediatric Endoscopy During COVID-19 Times

“…If a patient has a positive or inconclusive RT-PCR test, the procedure should be considered high risk and should only be conducted if the clinical situation demands ( 27 ). Furthermore, if a patient has current symptoms or is otherwise at high risk for current infection ( Table 1 ), but has such an urgent indication for endoscopy that there is inadequate time to have a nasopharyngeal swab, then their procedure should also be considered high risk ( 6 ).…”

“…While some early reports suggested that there was a low risk of COVID-19 transmission consequent to GI endoscopy ( 5 ), other reports indicated a high prevalence of SARS-CoV-2 infection in patients scheduled for digestive endoscopy ( 6 ). These contradictory reports resulted in confusion and uncertainty in decision making.…”