Patient perspective on safety of elective gastrointestinal endoscopy during the COVID-19 pandemic

Taneja, Vikas; El-Dallal, Mohammed; Bilal, Mohammad; Flier, Sarah N.; Sheth, Sunil G.; Ballou, Sarah K.; Berzin, Tyler M.; Pleskow, Douglas K.; Feuerstein, Joseph D.; Sawhney, Mandeep S.

BACKGROUND: Patients’ perception regarding the risks of COVID-19 infection with gastrointestinal (GI) and the preventive measures taken in GI endoscopy units to mitigate infection risk remains unclear. We aimed to assess patients’ perception regarding risks of COVID-19 with GI endoscopy and the changes in the endoscopy unit as a result of the ongoing pandemic. METHODS: Outpatients undergoing GI endoscopy at our institution were categorized into those scheduled to undergo GI endoscopy (pre-procedure) and those who had recently undergone GI endoscopy during the pandemic (post-procedure). Two separate but similar survey instruments were designed. Patients were asked to respond on a 5-point Likert scale. Responses were stratified as ‘low’, ‘neutral’ and ‘high’ for analysis. RESULTS: A total of 150 and 355 respondents completed the pre-procedure and post-procedure surveys, with a combined response rate of 82.5%. Non-white ethnicity was associated with reporting a ‘high’ level of concern for endoscopy related COVID-19 exposure in both the pre-procedure (OR 4.09, 95% CI 1.54-10.82) and post-procedure cohorts (OR 2.11, 95% CI 1.04-4.29). 42% of patients in the pre-procedure cohort and 11.8% in the post-procedure cohort reported their level of concern for COVID exposure as ‘high’. Among the post-procedure cohort, 88% of the patients were likely to undergo repeat endoscopy during the pandemic if recommended. CONCLUSION: Patients are willing to undergo GI endoscopy during the COVID-19 pandemic. Non-white and older patients, and those undergoing screening examinations were more concerned with the GI endoscopy related COVID-19 transmission risk.