Background and study aim: The coronavirus disease 2019 (COVID-19) substantially affected healthcare systems including endoscopy services worldwide. Besides using PPE, pre-procedure symptom screening was adopted by the majority. The role of polymerase chain reaction (PCR) testing in addition to symptom-based screening over a longer period that includes a post-pandemic environment needed further investigation. This study aimed to evaluate the outcome of COVID-19 screening using PCR testing in low-risk patients narrowed down by a symptom-based pre-procedure screening tool during five waves of COVID-19.
Patients and Methods: This cross-sectional study was performed from June 2020 to March 2022. Patients aged ≥ 18 years with no symptoms screened via COVID-19 risk screening questionnaire, who underwent endoscopy procedures at Aga Khan University Hospital, Karachi, were reviewed. Patients who already had positive COVID-19 tests or had COVID-19 in the preceding month were excluded. COVID-19 Reverse Transcriptase PCR on nasopharyngeal swabs was performed within 72 hours pre-procedure. World Health Organization (WHO) timelines were used to define time limits for five COVID-19 waves.‎
Results: Of 7198 patients booked for endoscopic procedures, 4967 (69.0%) patients were tested for COVID-19. The mean age was 47.6 ± 15.9 years and 44.9% were female. Overall COVID-19 positivity rate was 2.7% with the highest rate of 11.9% in the fifth COVID-19 wave followed by the first wave (2.4%).
Conclusion: There was a low overall occurrence of COVID-19 infection, apart from the fifth wave in asymptomatic patients undergoing endoscopic procedures. Therefore, increasing compliance with COVID-19 vaccination and conducting thorough symptom-based screening before endoscopic procedures could eliminate the necessity for RT-PCR testing‎.