Coronavirus (COVID-19) outbreak: what the department of endoscopy should know

Abstract

Italy recorded its first case of confirmed acute respiratory case due to Coronavirus on February 18, 2020, soon after the initial reports in China. Since that time, Italy and nations throughout the world have adopted very stringent and severe measures to protect populations from spread of infection.Despite these measures, the number of infected people is growing exponentially with a significant number of patients developing acute respiratory insufficiency. Endoscopy departments face significant risk for diffusion of respiratory diseases that can be spread via an airborne route, including aspiration of oral and fecal material via endoscopes. The purpose of this article is to discuss the measures, with specific focus on personal protection equipment and dressing code modalities, which have been implemented in our hospital to prevent further dissemination of COVID-19 infection.

Hepatic and gastrointestinal involvement in coronavirus disease 2019 (COVID-19): What do we know till now?

“…All endoscopy facilities should develop standard operating measures for COVID-19 prevention and control in conjunction with infection control team members, and share these widely among staff members [61]. Based on prior experience from SARS and our current understanding of epidemiological characteristics of COVID-19, the following steps should be implimented in endoscopy units: The assessment must include history of fever, respiratory symptoms, or diarrhea, history of contact with a suspected or confirmed case of COVID-19 and any recent travel to a high-risk area [61]. 3.…”

“…4. Staff protection: The minimal composition of personal protective equipment (PPE) for personnel in endoscopy units should include gloves, hairnet, protective eyewear (goggles or face shield), waterproof gowns, and respiratory protective equipment, modified on the basis of risk stratification [61]. The surgical facial mask is effective in blocking splashes and large-particle droplets, whereas, filtering facepiece (FFP) respirator class 2 or 3 (FFP2/FFP3) achieves efficient filtration of airborne particles (up to 0.3 mm) [65].…”

“…6. Decontamination of endoscopy rooms: This process should include cleaning all surfaces in the procedure room to remove all soil and biofilm, followed by proper disinfection [61]. Chlorine-containing detergents are recommended for floor cleaning every day [67].…”

“…To prevent SARS-CoV-2 transmission in endoscopy units during the current outbreak, a workflow is proposed ( Fig. 1) in accordance with recommendations of endoscopy societies [61][62][63][64][65][66].…”

Preventive strategies used by GI physicians during the COVID-19 pandemic

“…Initially, GI physicians must announced the patients that human-to-human transmission is the main way of infection via close contact or through air droplets in COVID-19 pandemic. Personal protective equipment such as surgical masks, gowns, face shield, gloves, hand disinfectants must be used by physicians during any medical care especially for endoscopy care that demand short physical distance between infected COVID-19 patients and physicians (4). On the other hands, due to the long duration time requirement and high possible of aspiration of oral and fecal material during endoscopy, we limited this protocol only for emergency patients.…”