Positivity Rate of Universal PCR Screening for COVID-19 Pre-Endoscopy and its Impact on Diagnosis and Management of New Cancer Patients at a Cancer Centre in Pakistan

Objective: To determine the positivity rate of COVID-19 on pre-procedure screening and its impact on diagnosis and management of new cancer patients. Study Design: Cross-sectional study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore Pakistan, from Sep 2020 to Aug 2021. Methodology: Data was retrospectively collected from electronic medical records of the patients, including their age, gender, PCR test result, date of first visit to the gastroenterology clinic, date of multidisciplinary team meeting and any adverse event reported due to delay in endoscopy procedure. Results: A total of 1273 patients underwent endoscopy procedures in the study period. Fifty-two patients were found to be COVID-positive (4.1%), and only one was symptomatic. The percentage of positivity in newly diagnosed 22 cancer patients was 1.72%. Of 52 patients, 31 were male (59.61%), and 21 were female (40.39%). Only 1 patient was presented with abdominal pain and revealed concealed perforation. No other adverse event was reported in any patient, and no new imaging was required before discussion in a multidisciplinary team meeting. Conclusion: The hospital policy of COVID PCR test 48 hours before the endoscopy procedure effectively isolates the asymptomatic positive COVID-19 patients. The two-week delay due to COVID-PCR positivity in newly diagnosed cancer patients was not associated with any adverse event, and no new imaging was required.