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

M Casper; M C Reichert; J Rissland; S Smola; F Lammert; M Krawczyk

doi:10.1186/s40001-022-00672-5

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

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

Authors

M Casper¹, M C Reichert², J Rissland³, S Smola³, F Lammert^{2

4}, M Krawczyk^{2

5}

Affiliations

¹ Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany. markus.casper@uks.eu.
² Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.
³ Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany.
⁴ Hannover Medical School, Hannover Health Sciences Campus, Hannover, Germany.
⁵ Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Center for Preclinical Research, Medical University of Warsaw, Warsaw, Poland.

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.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
COVID-19 / diagnosis*
COVID-19 Testing / statistics & numerical data*
Child
Child, Preschool
Endoscopy, Gastrointestinal / statistics & numerical data*
Female
Germany
Humans
Infant
Infant, Newborn
Male
Middle Aged
Pandemics
Preoperative Care / statistics & numerical data*
Retrospective Studies
SARS-CoV-2
Young Adult