The Impact of Face Shields on the Quality of Colonoscopy During the COVID-19 Pandemic (preprint)

Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic. Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group. Results: : In total, 1,359 patients were included in the study;the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p =0.202), ADR (38.59 vs. 38.97%, p =0.884) SSPDR (1.91 vs. 1.32%, p =0.388), and ANDR (3.98 vs. 3.97%, p =0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields. Conclusions: : The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.