A multi-centre prospective study of COVID-19 transmission following outpatient Gastrointestinal Endoscopy in the United Kingdom

Hayee, B.; The SCOTS project group,; East, J. E.; Rees, C. R.; Penman, I.

Message The COVID-19 pandemic has severely curtailed the practice of endoscopy (as an exemplar for outpatient diagnostic procedures) worldwide. Restart and recovery processes will be influenced by the need to protect patients and staff from disease transmission, but data on the risk of COVID-19 transmission after endoscopy are sparse. This is of particular importance in later pandemic phases when the risk of harm from delayed or missed significant diagnoses is likely to far outweigh the risk of infection. The British Society of Gastroenterology (BSG) guidance for restarting endoscopy included stratification of diagnostic procedures according to aerosol generation or assessment of infectious risk as well as pragmatic guidance on the use of personal protective equipment (PPE). We sought to document the risk of COVID-19 transmission after endoscopy in this 'COVID-minimised' environment. Prospective data were collected from 18 UK centres for n=6208 procedures, with follow-up telephone assessment of patients at 7 and 14 days. No cases of COVID-19 were documented by any centre after endoscopy in either patients or staff, with 3/2611 (0.11%) asymptomatic patients testing positive for SARS-CoV-2 on nasopharyngeal swab testing pre-endoscopy. While these data cannot determine the relative contribution of each component of a COVID-minimised pathway, they provide clear support for such an approach, are reassuring and should aid planning for outpatient diagnostics in the COVID-19 recovery phase.