Risk of COVID-19 transmission in esophageal, anorectal manometry, and 24-hour impedance-pH monitoring.

Background The impact of the COVID-19 pandemic has led to the interruption of most manometry or impedance-pH monitoring studies. The risk to restarting activities is unknown. Objective Assess the risk of SARS-Cov-2 virus contagion, both to patients and healthcare workers in relation to esophageal and anorectal functional tests during the pandemic without protective measures. Method A questionnaire was designed to find out whether patients and healthcare workers had COVID-19, confirmed either by a test or only compatible symptoms, after functional studies were performed from January until March 2020. Results 263 (92.9%) patients answered the survey. In the two weeks after functional test, four (1.52%) patients had confirmed COVID-19 (adjusted rate 8.34 cases per 1,000 (95% CI -0.06-16.74), OR 0.84 (95% CI: 0.83-0.85), p<0.001), no one after anorectal manometry. Other five had only compatible symptoms, total 9 (3.42%) (adjusted rate 27.50 cases / 1,000 (95% CI: 7.27-47.74), OR 2.84 (95% CI: 2.81-2.87). In the total study period 18.25% had COVID-19 confirmed or with compatible symptoms. The average of days between the procedure and the first day of symptoms was progressively shortened: January 56 days, February 33 days, March 10.5 days. Two out of 10 healthcare workers (20%) were confirmed with COVID-19. Conclusions The risk of COVID-19 contagion when performing functional tests is low and more related to the evolution of the pandemic than to the procedures themselves. The small number of healthcare workers included in the study does not allow a definitive conclusion to be drawn on their risk of contagion.