Poor agreement between clinical screening and universal pre-procedure SARS-CoV-2 PCR testing prior to endoscopy

Rev Esp Enferm Dig. 2021 Sep;113(9):649-655. doi: 10.17235/reed.2021.7612/2020.

Abstract

Introduction: scientific societies recommend screening for SARS-CoV-2 in patients prior to endoscopy. There is no solid evidence regarding the efficiency of universal screening by PCR testing for SARS-CoV-2. The present study aimed to assess the usefulness of clinical screening and universal pre-procedure PCR testing for the identification of patients capable of transmitting the SARS-CoV-2 infection. Concordance between both strategies was also evaluated.

Method: a retrospective review was performed in a consecutive cohort of patients undergoing endoscopy at a tertiary teaching hospital between April 22 and June 22, 2020, following a screening protocol.

Results: three hundred and sixty-one patients were included. Clinical screening detected 13 patients with a high risk of infection (3.6 %, 95 % CI: 2.62-4.58) while the pre-procedure PCR test was positive in five patients (1.40 %, 95 % CI: 0.20-2.60). Three patients developed COVID-19 and one died from the disease. Agreement between both strategies was poor, with a kappa value of 0.093 (95 % CI: 0.001-0.185). Clinical screening only identified one of the five patients with a positive PCR test.

Conclusion: clinical screening prior to endoscopy has a poor agreement with pre-procedure PCR testing.

MeSH terms

  • COVID-19*
  • Endoscopy
  • Humans
  • Polymerase Chain Reaction
  • Retrospective Studies
  • SARS-CoV-2*