The Role of Preprocedure Screening of SARS-CoV-2 Infection: A Tertiary Care Medical Center Analysis

Purpose: This study aimed to understand the prevalence of asymptomatic COVID-19 infection among patients undergoing endoscopic procedures at a tertiary care hospital. The results allow prediction of the magnitude of cases which this endoscopic service might witness in the next months and planning of future actions accordingly. Methods: This retrospective study was conducted in the gastroenterology department of a large urban tertiary care medical center from October 15, 2020, to November 15, 2020. In this institution, all patients proposed for endoscopic procedures under deep sedation must be submitted to reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) detection. These results were thoroughly reviewed. Results: In the 1-month period, a total of 833 different procedures were done in 833 patients admitted to the endoscopy unit. Of these, 167 (20%) were submitted to nasal swab for SARS-CoV-2. Only 1 (0.6%) was positive for this infection, and her procedure was postponed. This RT-PCR-positive patient was not symptomatic for CO-VID-19 infection at the time of preprocedure screening. She had no positive contacts for COVID-19 and had not traveled outside the country. Conclusion: We found that the proportion of patients proposed for an endoscopic intervention who were asymptomatic carriers of SARS-CoV-2 was low. However, only one fifth of patients were tested and, considering the proportion of 0.6%, it is reasonable to consider that exposure of healthcare workers and other patients can occur. So, all prevention measures must be strictly followed. However, the cost-benefit of an universal testing policy must be proven.