AGA rapid review and guideline for SARS-CoV2 testing and endoscopy post-vaccination: 2021 update
Gastroenterology
; 161(3): 1011-1029, 20210901. rev.
Article
in English
| BIGG - GRADE guidelines
| ID: biblio-1292466
Responsible library:
BR1.1
ABSTRACT
This guideline provides updated recommendations on the role of preprocedure testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in individuals undergoing endoscopy in the post-vaccination period and replaces the prior guideline from the American Gastroenterological Association (AGA) (released July 29, 2020). Since the start of the pandemic, our increased understanding of transmission has facilitated the implementation of practices to promote patient and health care worker (HCW) safety. Simultaneously, there has been increasing recognition of the potential harm associated with delays in patient care, as well as inefficiency of endoscopy units. With widespread vaccination of HCWs and the general population, a re-evaluation of AGA's prior recommendations was warranted. In order to update the role of preprocedure testing for SARS-CoV2, the AGA guideline panel reviewed the evidence on prevalence of asymptomatic SARS-CoV2 infections in individuals undergoing endoscopy; patient and HCW risk of infections that may be acquired immediately before, during, or after endoscopy; effectiveness of COVID-19 vaccine in reducing risk of infections and transmission; patient and HCW anxiety; patient delays in care and potential impact on cancer burden; and endoscopy volumes. The panel considered the certainty of the evidence, weighed the benefits and harms of routine preprocedure testing, and considered burden, equity, and cost using the Grading of Recommendations Assessment, Development and Evaluation framework. Based on very low certainty evidence, the panel made a conditional recommendation against routine preprocedure testing for SARS-CoV2 in patients scheduled to undergo endoscopy. The panel placed a high value on minimizing additional delays in patient care, acknowledging the reduced endoscopy volumes, downstream impact on delayed cancer diagnoses, and burden of testing on patients.
Full text:
Available
Collection:
Tematic databases
Health context:
SDG3 - Target 3.3 End transmission of communicable diseases
Health problem:
Pneumonia
Database:
BIGG - GRADE guidelines
Main subject:
COVID-19 Testing
/
COVID-19
Type of study:
Practice guideline
/
Risk factors
/
Systematic review
Language:
English
Journal:
Gastroenterology
Year:
2021
Document type:
Article
Institution/Affiliation country:
Beth Israel Deaconess Medical Center/US
/
Brown University/US
/
University of California San Diego/US
/
University of Kansas Medical Center/US
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University of Minnesota/US
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University of Pennsylvania/US
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University of Rochester Medical Center/US
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University of Utah/US
/
Washington University/US
/
Western Reserve University/US