S0532 Pre-Procedure COVID-19 Screening and SARS-CoV-2 Testing in a Large Community-Based Ambulatory Surgical Center (ASC) in SE Michigan

Abstract

INTRODUCTION: The role of pre-procedure COVID-19 testing in outpatient endoscopy centers remains unclear, especially in areas with declining incidence and prevalence of infection. We developed a strategy utilizing symptom screening and SARS-CoV-2 viral RT-PCR testing in patients referred for elective endoscopy at a large community-based ASC in SE Michigan. We hypothesize that this dual screening approach will allow better detection of symptomatic and asymptomatic carriers of COVID-19. METHODS: A retrospective review of all patients referred for elective outpatient endoscopy during a 3 week period (May 20–June 12, 2020) was conducted. Patients were initially screened for exposure history and symptoms of COVID-19 at the time of procedure scheduling, again 3 days prior to the procedure, and on the actual day of the procedure. All patients were offered SARS-CoV-2 RT-PCR testing 48 hours prior to the scheduled procedure and then advised to follow CDC guidelines of social distancing, donning a face mask and frequent hand hygiene until endoscopy. Uptake of COVID-19 testing, barriers, and impact on subsequent endoscopy were evaluated. RESULTS: 718 consecutive patients were scheduled for elective outpatient endoscopy. All patients were symptom screened and 642 patients (89%) underwent COVID-19 PCR testing within 48 hours of their scheduled procedures. 2 patients reported fevers within 48 hours of their scheduled endoscopy, leading to cancellation. COVID-19 PCR testing of asymptomatic patients (n = 642) revealed no positive results. A total of 76 patients (11%) did not undergo viral testing. Barriers to COVID-19 testing included limited time interval between scheduling and procedure, patient reported challenges with travel/availability, and negative perceptions about testing. CONCLUSION: This study demonstrates the feasibility and successful implementation of a pre-procedure COVID-19 screening program in a busy endoscopy center. The dual process of clinical screening for symptomatic patients and viral testing of asymptomatic patients optimizes the likelihood of identifying pre-procedure patients with COVID-19. Although there is a low yield of positive viral tests in settings with low disease prevalence, this study forms a framework to expand pre-procedure screening and testing to enhance safety for our patients and staff during the COVID-19 pandemic.