Oakland University William Beaumont School of Medicine Troy, MI
John R. Weber, MD1, Partha S. Nandi, MD2, Melissa Alderson, RN3, Leonard G. Quallich, III, MD3; 1Oakland University William Beaumont School of Medicine, Troy, MI; 2Center for Digestive Health, Rochester Hills, MI; 3Troy Gastroenterology, Troy, MI
Introduction: The role of pre-procedure COVID-19 testing in outpatient endoscopy centers remains unclear, especially in areas with declining incidence and prevalence of infection. We developed a strategy utilizing symptom screening and SARS-CoV-2 viral RT-PCR testing in patients referred for elective endoscopy at a large community-based ASC in SE Michigan. We hypothesize that this dual screening approach will allow better detection of symptomatic and asymptomatic carriers of COVID-19. Methods: A retrospective review of all patients referred for elective outpatient endoscopy during a 3 week period (May 20-June 12, 2020) was conducted. Patients were initially screened for exposure history and symptoms of COVID-19 at the time of procedure scheduling, again 3 days prior to the procedure, and on the actual day of the procedure. All patients were offered SARS-CoV-2 RT-PCR testing 48 hours prior to the scheduled procedure and then advised to follow CDC guidelines of social distancing, donning a face mask and frequent hand hygiene until endoscopy. Uptake of COVID-19 testing, barriers, and impact on subsequent endoscopy were evaluated. Results: 718 consecutive patients were scheduled for elective outpatient endoscopy. All patients were symptom screened and 642 patients (89%) underwent COVID-19 PCR testing within 48 hours of their scheduled procedures. 2 patients reported fevers within 48 hours of their scheduled endoscopy, leading to cancellation. COVID-19 PCR testing of asymptomatic patients (n=642) revealed no positive results. A total of 76 patients (11%) did not undergo viral testing. Barriers to COVID-19 testing included limited time interval between scheduling and procedure, patient reported challenges with travel/availability, and negative perceptions about testing. Discussion: This study demonstrates the feasibility and successful implementation of a pre-procedure COVID-19 screening program in a busy endoscopy center. The dual process of clinical screening for symptomatic patients and viral testing of asymptomatic patients optimizes the likelihood of identifying pre-procedure patients with COVID-19. Although there is a low yield of positive viral tests in settings with low disease prevalence, this study forms a framework to expand pre-procedure screening and testing to enhance safety for our patients and staff during the COVID-19 pandemic.
Disclosures: John Weber indicated no relevant financial relationships. Partha Nandi indicated no relevant financial relationships. Melissa Alderson indicated no relevant financial relationships. Leonard Quallich indicated no relevant financial relationships.