To the Editor:
We read with interest the article by Repici et al,1 describing all measures to adopt to minimize the dissemination of SARS-CoV-2 infection during endoscopic procedures. By using such processes, another Italian endoscopic unit reported no cases of transmission up to May 1, 2020.2 Subsequently, to guarantee patients and healthcare workers (HCWs) additional protection, serologic screening of the HCWs was also implemented. No cases of infection occurred, thus suggesting that all recommendations were efficient in preventing SARS-CoV-2 infection.
We report our experience from a referral center in Rome that was fully involved in SARS-CoV-2 patient care. At least up to August 2020, SARS-CoV-2 infection was limited in comparison with the north of Italy. However, HCWs wore personal protective equipment and observed proper hand hygiene. To improve safety in the outpatient setting, screening with rapid serologic testing (IgG/IgM rapid test) was used between August and October 2020, even for asymptomatic outpatients. From November to December 2020, because of an increase in the overall SARS-CoV-2 cases in Italy, screening of both outpatients and HCWs was established with use of the antigenic nasopharyngeal swab.
We describe the risk of SARS-CoV-2 infection among HCWs divided into 3 time interval periods, during which different screening procedures were used as described above (Table 1 ). In all, 6936 outpatient procedures were performed. During the first and second phases, no cases of infection among HCWs were recorded. Conversely, in the last period, 10 out of 40 (25%) HCWs had positive test results with the antigenic nasopharyngeal swab, confirmed with the molecular test. Most of them were asymptomatic, with only 3 individuals reporting mild symptoms without the need for hospitalization.
Table 1.
Procedures and screening test
| Period | Outpatient procedures | Test | No. of positive results |
|
|---|---|---|---|---|
| HCW | Patients | |||
| March–July | 2721 | N.A. | 0 | N.A. |
| August–October | 2273 | Rapid serologic test | 0 | 16 |
| November–December | 1942 | Antigenic nasopharyngeal swab | 10 | 32 |
HCW, Healthcare worker; N.A., not applicable.
In our experience, screening with the antigenic nasopharyngeal swab should be implemented in both outpatients and HCWs to provide a more effective method to detect asymptomatic infected individuals and to prevent spreading of SARS-CoV-2 infection.
Disclosure
All authors disclosed no financial relationships.
References
- 1.Repici A., Maselli R., Colombo M. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020;92:192–197. doi: 10.1016/j.gie.2020.03.019. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Minelli Grazioli L., Milluzzo S.M., Spada C. Safe endoscopy during the COVID-19 pandemic. Gastrointest Endosc. 2020;92:1274–1275. doi: 10.1016/j.gie.2020.07.058. [DOI] [PMC free article] [PubMed] [Google Scholar]