S630 Universal Pre-Procedure COVID-19 Testing and Its Impact on Health Care

Abstract

Introduction: Centers for Disease Control and Prevention (CDC) and gastrointestinal professional societies in April 2020 introduced pre-procedure testing for SARS-CoV2 in patients undergoing elective surgeries and procedures. However, with declining rates of COVID-19 infection in the community this strategy delays important screening procedures as well as puts substantial burden on healthcare system. Methods: In a retrospective cohort study, we collected data on patients who underwent screening SARS-CoV2 testing prior to elective procedures and surgeries at our facility during the study period May 2020 to June 2021. Additionally, we collected data on screening SARS-CoV2 test performed on patients prior to screening colonoscopy. Descriptive analysis was performed. Results: A total of 45,455 screening SARS-CoV2 tests were performed prior to elective surgery or procedures at our facility of which 1245 (2.7%) patients tested positive. Positivity rate paralleled the infection rate in our community and ranged from 0.4% - 7.1% (Figure 1a). During the study period, 2109 screening colonoscopies were scheduled along with pre procedure SARS-CoV2 test completed. A total of 92 (4.4%) pre procedure tests were reported positive leading to deferral of the procedure. Among these 92 patients, 66.3% patients did not return for a procedure on a rescheduled date (Figure 1b). Conclusion: In regions with low COVID-19 infection rates, routine screening for SARS-CoV2 may have minimal yield and this strategy should be revaluated. Deferral of screening colonoscopy due to positive SARS – COV2 testing led to high non-adherence upon rescheduling in these asymptomatic patients.Figure 1.: Panel A- Positivity rate for screening SARS – COV2 test prior to elective surgeries and procedures; Panel B - Positivity rate for screening SARS – COV2 test prior to elective screening colonoscopies.