Covid-19: current prevention tools in endoscopy units

Covid-19 : Herramientas de prevención actual en las unidades de endoscopia

In late 2019, SARS-CoV-2, a new coronavirus causing COVID-19, emerged in Wuhan (China). As of April 13 2020 it has caused 1.807.308 infections and 119.410 deaths worldwide. Due to the way this virus is transmitted and considering gastroenterology and digestive endoscopy services are a source of easy dissemination given the constant exposure with aerosols that are emitted during procedures there is an increased risk for both health care professionals and patients undergoing endoscopy. It is of great importance to establish prevention tools within the gastroenterology and digestive endoscopy services, based on the evidence gathered to date and recognizing that we are in a constant search for measures to reduce risk of infection that will provide a safe environment to staff and patients. Pubmed database was searched for the following terms: (“COVID-19” OR “coronavirus” OR “SARS-Cov-2”) and (“gastrointestinal” OR “transmission” OR “intestinal” OR “digestive” OR “endoscopy” OR “esophagogastroduodenoscopy” OR “colonoscopy”). Therefore, all patients brought in to undergo endoscopic procedures should be considered high-risk and current prevention tools will be made known worldwide.

1. Instituto Nacional de Salud. Coronavirus (COVID - 2019) en Colombia [Internet]. Colombia: Instituto Nacional de Salud; 2020 [citado 2020 marzo 22]; Recuperado de: https://www.ins.gov.co/Noticias/Paginas/Coronavirus.aspx.
2. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 56. Reporte. World Health Organization, 2020.
3. Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection. The Lancet Infec Dis. 2020. doi: https://doi.org/10.1016/S1473-3099(20)30195-X.
4. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. doi: https://doi.org/10.1016/S0140-6736(20)30251-8.
5. Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020. doi: https://doi.org/10.1007/s11684-020-0754-0.
6. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020.
7. Luo S, Zhang X, Xu H. Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19). Clin Gastroenterol Hepatol. 2020. https://doi.org/10.1016/j.cgh.2020.03.043.
8. Repici A, Maselli R, Colombo M, Gabbiadini R, Spadaccini M, Anderloni A, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020. https://doi.org/10.1016/j.gie.2020.03.019.
9. Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud. Recomendaciones basadas en consenso de expertos e informadas en la evidencia. Infectio. 2020;24(3):1-45.
10. American Society for Gastrointestinal Endoscopy. JOINT GI SOCIETY MESSAGE: COVID-19 Clinical Insights for Our Community of Gastroenterologists and Gastroenterology Care Providers [Internet]. American Society for Gastrointestinal Endoscopy; 2020 [cited 2020 marzo 22]; Available from: https://www.gastro.org/press-release/joint-gi-society-message-covid-19-clinical-insights-for-our-community-of-gastroenterologists-and-gastroenterology-care-providers.
11. Zhang Y, Zhang X, Liu L, Wang H, Zhao Q. Suggestions for infection prevention and control in digestive endoscopy during current 2019-nCoV pneumonia outbreak in Wuhan, Hubei province, China. Endoscopy. 2020;52(4):312-4. doi: https://doi.org/10.1055/a-1128-4313.
12. Sociedad Interamericana de Endoscopia Digestiva. Recommendations for the endoscopy units during the coronavirus infection outbreak (covid-19). Sociedad Interamericana de Endoscopia Digestiva; 2020. p. 10.
13. Gralnek IM, Hassan C, Beilenhoff U, Antonelli G, Ebigbo A, Pellise M, et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy. 2020. doi: https://doi.org/10.1055/a-1155-6229.
14. Cao Z, Zhang Q, Lu X, Pfeiffer D, Jia Z, Song H, et al. Estimating the effective reproduction number of the 2019-nCoV in China. medRxiv. 2020:2020.01.27.20018952. doi: https://doi.org/10.1101/2020.01.27.20018952
15. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention; 2020 [cited 2020 marzo 22]; Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-faq.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Finfection-control%2Finfection-prevention-control-faq.html.
16. Otero W, Gómez Zuleta MA, Angel Arango LA, Ruíz Morales OF, Fernández HM, Riveros J, et al. Procedimientos endoscópicos y pandemia COVID19. Consideraciones básicas. Rev Colomb Gastroenterol. 2020;35(1):65-75. doi: https://doi.org/10.22516/25007440.526
17. European Centre for Disease Prevention and Control. Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. Stockholm: European Centre for Disease Prevention and Control; 2020. p. 13.
18. Chen X, Shang1 Y, Yao1 S, Liu R, Liu H. Perioperative Care Provider’s Considerations in Managing Patients with the COVID-19 Infections. Transl Perioper & Pain Med. 2020;7(2):216-24. doi: https://doi.org/10.31480/2330-4871/116
19. Sociedad Española de Endoscopia Digestiva (SEED). Recomendaciones de la SEED: Protección en Unidades de Endoscopia frente al COVID-19 [Internet]. Madrid España: Sociedad Española de Endoscopia Digestiva; 2020 [cited 2020 marzo 22]; Available from: https://www.wseed.org/~josepr23/sociedades/SEEDv3/images/site/guia_clinica/2020/RecomendacionesSEED_UnidadesEndoscopia_COVID19_v1.pdf.
20. Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. The digestive system is a potential route of 2019-nCov infection: a bioinformatics analysis based on single-cell transcriptomes. bioRxiv. 2020:2020.01.30.927806. doi: https://doi.org/10.1101/2020.01.30.927806
21. Calderwood AH, Day LW, Muthusamy VR, Collins J, Hambrick RD, 3rd, Brock AS, et al. ASGE guideline for infection control during GI endoscopy. Gastrointestinal endoscopy. 2018;87(5):1167-79. Doi: https://doi.org/10.1016/j.gie.2017.12.009
22. Beilenhoff U, Biering H, Blum R, Brljak J, Cimbro M, Dumonceau JM, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) - Update 2018. Endoscopy. 2018;50(12):1205-34. doi: https://doi.org/10.1055/a-0759-1629.