Aparato Digestivo, Hospital Universitario Son Espases, España.
Microbiología, Hospital Universitario Son Espases, España.
Rev Esp Enferm Dig. 2021 Sep;113(9):649-655. doi: 10.17235/reed.2021.7612/2020.
scientific societies recommend screening for SARS-CoV-2 in patients prior to endoscopy. There is no solid evidence regarding the efficiency of universal screening by PCR testing for SARS-CoV-2. The present study aimed to assess the usefulness of clinical screening and universal pre-procedure PCR testing for the identification of patients capable of transmitting the SARS-CoV-2 infection. Concordance between both strategies was also evaluated.
a retrospective review was performed in a consecutive cohort of patients undergoing endoscopy at a tertiary teaching hospital between April 22 and June 22, 2020, following a screening protocol.
three hundred and sixty-one patients were included. Clinical screening detected 13 patients with a high risk of infection (3.6 %, 95 % CI: 2.62-4.58) while the pre-procedure PCR test was positive in five patients (1.40 %, 95 % CI: 0.20-2.60). Three patients developed COVID-19 and one died from the disease. Agreement between both strategies was poor, with a kappa value of 0.093 (95 % CI: 0.001-0.185). Clinical screening only identified one of the five patients with a positive PCR test.
clinical screening prior to endoscopy has a poor agreement with pre-procedure PCR testing.
科学协会建议在进行内镜检查之前对 SARS-CoV-2 患者进行筛查。目前尚无关于对 SARS-CoV-2 进行 PCR 检测的通用筛查的效率的可靠证据。本研究旨在评估临床筛查和通用术前 PCR 检测对识别有能力传播 SARS-CoV-2 感染的患者的有效性。还评估了这两种策略之间的一致性。
对 2020 年 4 月 22 日至 6 月 22 日期间在一家三级教学医院接受内镜检查的连续队列患者进行了回顾性研究，该队列遵循筛查方案。
共纳入 361 名患者。临床筛查发现 13 例具有高感染风险的患者（3.6%，95%CI：2.62-4.58），而术前 PCR 检测在 5 例患者中呈阳性（1.40%，95%CI：0.20-2.60）。有 3 例患者发生 COVID-19，1 例患者死于该病。两种策略之间的一致性较差，kappa 值为 0.093（95%CI：0.001-0.185）。临床筛查仅识别出 5 例 PCR 检测阳性患者中的 1 例。
内镜检查前的临床筛查与术前 PCR 检测一致性较差。
