Subscribe to RSS
DOI: 10.1055/a-1526-1169
Evaluation of the ESGE recommendations for COVID-19 pre-endoscopy risk-stratification in a high-volume center in Germany
Abstract
Background and study aims The European Society of Gastrointestinal Endoscopy (ESGE) has defined COVID-19 infection prevention and control strategies within the endoscopy unit. These include pre-endoscopic questionnaire-based risk-stratification as well as pre-procedure viral testing. Real-life data on the effectiveness of these measures are presented here.
Patients and methods Data from the outpatient endoscopic unit of the University Hospital Augsburg between July 1, 2020 and December 31, 2020 including the second pandemic wave were reviewed retrospectively. All patients were assessed with a pre-endoscopic risk-stratification questionnaire as well as viral testing using an antigen point-of-care test (Ag-POCT) in conjunction with a standard polymerase chain reaction (PCR) test. Highly elective procedures were postponed. The theoretically expected number of SARS-CoV-2-positive patients was simulated and compared with the actual number. In addition, endoscopy staff was evaluated with a rapid antibody test to determine the number of infections among the personnel.
Results In total, 1029 procedures, 591 questionnaires, 591 Ag-POCTs, and 529 standard PCR tests were performed in 591 patients. 247 procedures in 142 patients were postponed. One Ag-POCT was positive but with a negative PCR test, while one PCR test was positive but with a negative Ag-POCT. This was lower than the theoretically expected number of COVID-19-positive patients (n = 15). One of 43 employees (2.3 %) in the outpatient endoscopy unit was seropositive.
Conclusions Pre-endoscopic risk management including questionnaire-based risk stratification and viral testing seems to be an effective tool in combination with personal protective equipment for SARS-CoV-2 infection prevention and control within the endoscopy unit even in a high-prevalence setting.
Publication History
Received: 11 March 2021
Accepted: 25 May 2021
Article published online:
16 September 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Repici A, Maselli R, Colombo M. et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc 2020; 92: 192-197
- 2 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020; 158: 1518-1519
- 3 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; 52: 483-490
- 4 Hennessy B, Vicari J, Bernstein B. et al. Guidance for resuming GI endoscopy and practice operations after the COVID-19 pandemic. Gastrointest Endosc 2020; 92: 743-747 e741
- 5 Sultan S, Altayar O, Siddique SM. et al. AGA Institute Rapid review of the gastrointestinal and liver manifestations of COVID-19, meta-analysis of international data, and recommendations for the consultative management of patients with COVID-19. Gastroenterology 2020; 159: 320-334 e327
- 6 Ebigbo A, Rommele C, Bartenschlager C. et al. Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment. Endoscopy 2021; 53: 156-161
- 7 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey. Endoscopy 2020; 52: 891-898
- 8 Sultan S, Siddique SM, Altayar O. et al. AGA Institute rapid review and recommendations on the role of pre-procedure SARS-CoV-2 testing and endoscopy. Gastroenterology 2020; 159: 1935-1948 e1935
- 9 Forde JJ, Goldberg D, Sussman D. et al. Yield and implications of pre-procedural COVID-19 polymerase chain reaction testing on routine endoscopic practice. Gastroenterology 2020; 159: 1538-1540
- 10 Benatia D, Godefroy R, Lewis J. Estimating COVID-19 prevalence in the United States: a sample selection model approach. medRxiv 2020;
- 11 Stadt Augsburg. Coronavirus – Fallzahlen Augsburg [cited 8 March 2021]. 2021 Available from: https://www.augsburg.de/umwelt-soziales/gesundheit/coronavirus/fallzahlen
- 12 Pritsch M, Radon K, Bakuli A. et al. Prevalence and Risk factors of infection in the representative COVID-19 cohort Munich. Preprint 2020.
- 13 DunklezifferRadar e.V. Covid-19 Dunkelzifferradar. 2021 Available from: (access date 25.02.2021) https://covid19.dunkelzifferradar.de
- 14 Cronin UP, Girardeaux L, O'Meara E. et al. Protein A-Mediated binding of staphylococcus spp. to antibodies in flow cytometric assays and reduction of this binding by using Fc receptor blocking reagent. Appl Environ Microbiol 2020; 86
- 15 Tom MR, Mina MJ. To interpret the SARS-CoV-2 Test, consider the cycle threshold value. Clin Infect Dis 2020; 71: 2252-2254
- 16 Repici A, Aragona G, Cengia G. et al. Low risk of COVID-19 transmission in GI endoscopy. Gut 2020; 69: 1925-1927
- 17 Hayee B, East J, Rees CJ. et al. Multicentre prospective study of COVID-19 transmission following outpatient GI endoscopy in the UK. Gut 2021; 70: 825-828
- 18 Perez-Garcia F, Romanyk J, Gomez-Herruz P. et al. Diagnostic performance of CerTest and Panbio antigen rapid diagnostic tests to diagnose SARS-CoV-2 infection. J Clin Virol 2021; 137: 104781