SARS-CoV2 Testing Prior to Endoscopy: Discrepancy Between Estimated and True Asymptomatic Prevalence Rates in a Community-Based Gastroenterology Practice

and proportions using Pearson’s Chi Square test. Results: There were 165,175 ED visits for foreign bodies in 2018 in the United States, which was comparable to the number of ED visits for ST elevation myocardial infarction (STEMI) in the same year (177,254). Of all foreign bodies, 128,498 (78%) were ingested, with 40.8% found in the esophagus or stomach. The mean patient age was 19.8 (95% CI [18.8-20.8]) years and 56% were males. Most patients (84%) were discharged from the ED. Psychiatric comorbidity was 8 fold higher among patients who were admitted compared with those who were not (45.8% versus 5.1%, P , 0.01). The number of procedures was lower in the hospital than in the ED. However, more invasive and morbid procedures (laparotomy, endoscopy) were performed in the hospital. Mortality, although low, occurred only after admission (0% in ED versus 0.24% in the hospital, P 5 0.02). The mean length of stay was 4.5 (95% CI [3.8, 5.2]) days. The mean total hospitalization charges were 13 fold higher among admitted patients compared with those who were not ($44,704 versus $3,439, P , 0.01), resulting in a cumulative healthcare financial burden of $772 million (ED: $392 million, hospital: $380 million). Conclusion: ED visits for foreign bodies are as common as those for STEMI. The majority of foreign bodies are ingested and found in the esophagus or stomach. Psychiatric comorbidity is highly associated with hospital admission, surgical procedures, mortality and substantially higher healthcare utilization. Thus, mental health treatment is a high-yield target for decreasing mortality, morbidity, and more than half the healthcare financial burden in this setting.