Justin Forde, MD1, David Goldberg, MD2, Daniel A. Sussman, MD, MSPH3, Frederick Soriano, BSN, RN, CGRN4, Jodie A. Barkin, MD3, Sunil Amin, MD2; 1Jackson Memorial Hospital, Miami, FL; 2University of Miami, Jackson Memorial Hospital, Miami, FL; 3University of Miami Miller School of Medicine, Miami, FL; 4University of Miami Hospital, Miami, FL
Introduction: Current GI society recommendations on resuming endoscopy in the COVID-19 era are based on expert consensus with limited data. Previously, we reported routine COVID-19 PCR testing of asymptomatic patients prior to societal reopening may be low-yield despite theoretically decreasing staff exposure to carriers. The impact of societal reopening on pre-procedure testing remains unknown. The aim of this study is to compare yield of routine COVID-19 testing of asymptomatic individuals prior to endoscopy pre- and post-societal reopening.
Methods: This retrospective cohort study reviewed all patients undergoing endoscopic procedures at our combined inpatient/outpatient facility 4/13/2020 to 6/15/2020. Outpatients were called prior to the planned procedure with a COVID-19 screening questionnaire. Patients with flagged responses during this verbal screening were postponed. Those with negative verbal screening underwent PCR testing. Patients with a negative PCR underwent procedure, whereas positive PCR patients were rescheduled. Inpatients requiring procedures received a rapid in-house test. Emergent cases were performed regardless of the test result using full barrier personal protective equipment. Patients were again screened verbally and temperature checked day of procedure. The proportion of positive tests pre and post re-opening were compared with the Fisher’s exact test. Our data were compared to publicly available population-based test results from our county, Miami-Dade, FL.
Results: 1,406 PCR swabs were performed of which 4 patients were positive (test positive rate: 0.28%, 95% CI: 0.08-0.72%). During the pre-opening period, 1 of 396 PCR swabs was positive (percent positive: 0.25%, 95% CI: 0.01-1.4%). Post-opening, 3 of 1,010 PCR swabs were positive (percent positive: 0.30%, 95% CI: 0.06-0.87%). There was no difference in the rate of positive tests pre and post societal re-opening (0.25% vs 0.30%, p > 0.99). Demographic data qualify our county as intermediate prevalence for COVID-19. There have been no reported COVID-19 cases among our endoscopy staff.
Discussion: Despite a significant increase in procedural volume post-societal reopening, rates of asymptomatic COVID infections remained stable compared to pre-reopening. Verbal screening tools remain effective, but not perfect, in identifying patients who should have their procedure deferred in intermediate prevalence areas. PCR testing may play an adjunctive role to prevent exposure from asymptomatic or pre-symptomatic patients.
Disclosures: Justin Forde indicated no relevant financial relationships. David Goldberg indicated no relevant financial relationships. Daniel Sussman indicated no relevant financial relationships. Frederick Soriano indicated no relevant financial relationships. Jodie Barkin indicated no relevant financial relationships. Sunil Amin indicated no relevant financial relationships.