Covid-19 Transmission Risk Following Endoscopy During Endoscopy Activity Reduction At First UK Lockdown

Aims The rate of incidence and outcome of COVID-19 infection following endoscopic procedures during the first UK lockdown period was evaluated. We also assessed risk factors for transmission of COVID-19 infection post-endoscopy.

Methods Patients who had endoscopic procedures in our unit from 23/3/2020 to 31/5/2020 were included. During this period, only emergency and urgent procedures were undertaken. Follow up calls were made subsequently to all patients to enquire about COVID-19 symptoms, hospital admissions and COVID-19 testing within 14 days of their procedures. To identify risk factors for COVID-19 transmission post-endoscopy, we performed binominal logistic regression.

Results 391 endoscopies were included (table). 1.5 % (6/391) patients developed COVID-19 symptoms post-endoscopy. Median age is 80 (mean 75.8) with female to male ratio 2:1. The most common symptoms were fever, cough and breathlessness 83.3 % (5/6). The percentage of the confirmed cases by COVID-19 PCR swab test was 1.3 % (5/391). The median days that those 5 patients developed confirmed COVID-19 post-endoscopy was 7 (range 3-13). 0.8 % (3/391) died from COVID-19-related complications within 30 days after endoscopic procedure. One had gastroscopy, one flexible sigmoidoscopy and one ERCP, these procedures were performed on different dates and by different teams. The unadjusted 30-days all-cause mortality rate post-endoscopy was 3.6 % (14/391), all of them were inpatients.

On univariate binominal logistic regression, age as a continuous variable (OR 1.122; 95 % CI [1.021-1.234]; p = 0.017), less than 10 day hospital stay (OR 0.057; 95 % CI [0.008–0.400]; p = 0.004) and hospital stay between 11-20 days (OR 0.067; 95 % CI [0.005–0.842]; p = 0.036) were associated with COVID-19 transmission. Combining the above factors into a multivariable regression model, no factor achieved statistical significance.

Tab. 1

Procedure: Inpatients (IP)/Outpatients (OP)	Post Endoscopy COVID-19 Symptoms within 2 weeks IP/OP	Post Endoscopy COVID-19 positive IP/OP	30 days post endoscopy hospital admission IP/OP	Unadjusted 30 days Mortality IP/OP
Gastroscopy: (159/45)	2/1	2/0	0/0	11/0
Lower GI endoscopy: (38/65)	1/0	1/0	0/0	2/0
Endoscopic ultrasound: (4/3)	1/0	1/0	0/0	0/0
Endoscopic retrograde cholangiopancreatography:(5/14)	1/0	1/0	0/4	1/0

Conclusions The risk of transmission of clinical COVID-19 seems to be low for patients in the context of endoscopy procedures when the appropriate personal protective measures are in place. No risk factor reached statistical significance.

Citation Al-Rifaie A, Gawn A, Woodun H et al. eP493 COVID-19 TRANSMISSION RISK FOLLOWING ENDOSCOPY DURING ENDOSCOPY ACTIVITY REDUCTION AT FIRST UK LOCKDOWN. Endoscopy 2021; 53: S260.

Publication History

Article published online:
19 March 2021