Introduction: Endoscopic procedures have an increased risk for COVID-19 transmission due to their production of respiratory droplets and aerosolized particles. Early case reports and surveys suggest that transmission risk during endoscopy is low given proper personal protective equipment (PPE) usage. However, the advent of new virus variants led to renewed concern regarding infection risk. We examined how these recent trends have affected patterns of COVID-19 positivity, endoscopy center pre-procedure screening protocols, PPE usage, and healthcare provider perceptions of safety in endoscopy.
Methods: We surveyed gastroenterologists, nurses, technicians, and other endoscopy unit personnel throughout the United States. The survey was sent on November 1, 2021 and November 15, 2021, and assessed patterns of COVID-19 positivity among providers, vaccination status, COVID-19 testing protocols, and PPE usage.
Results: Seventy-two individuals responded to the survey with a self-reported vaccination rate of 100%. Nine individuals (13%) reported testing positive for COVID-19, all of whom tested positive before vaccination. Fifty-one (71%) endoscopy workers received the booster dose, and 13 (18%) endoscopy workers planned to in the future. Seven (10%) had not received a booster dose and did not plan to, even if available. Forty-three (60%) individuals reported that their endoscopy center mandated routine COVID-19 testing for all patients undergoing endoscopy. Sixty-one respondents (85%) reported feeling safer performing endoscopic procedures after vaccination (Table).
Discussion: In our cohort, no individuals tested positive for COVID-19 after receiving their first vaccination series, compared to 9 individuals who tested positive before vaccination. Most endoscopy workers received the booster dose or plan to once available, and most report feeling safer during endoscopy post-vaccination. Although the American Gastroenterological Association had recommended against routine COVID-19 screening prior to elective endoscopy, 60% of respondents reported that their endoscopy center mandated routine pre-procedural screening. Our findings suggest that even with the advent of the highly transmissible Delta variant in early 2021, COVID-19 transmission during endoscopy remained low given vaccination and proper PPE utilization. Further data is needed to shape practice-changing guidelines regarding booster vaccine mandates and pre-procedural screening in high-risk fields such as endoscopy.
