ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey

Gralnek, Ian M.; Hassan, Cesare; Beilenhoff, Ulrike; Antonelli, Giulio; Ebigbo, Alanna; Pellisé, María; Arvanitakis, Marianna; Bhandari, Pradeep; Bisschops, Raf; Hooft, Jeanin E. van; Kamiński, Michał; Triantafyllou, Konstantinos; Webster, George; Voiosu, Andrei; Pohl, Heiko; Dunkley, Irene; Fehrke, Björn; Gazic, Mario; Gjergek, Tatjana; Maasen, Siiri; Waagenes, Wendy; Pater, Marjon de; Ponchon, Thierry; Siersema, Peter D.; Messmann, Helmut; Dinis-Ribeiro, Mário

doi:10.1055/a-1213-5761

Cited by 67 publications

(85 citation statements)

References 24 publications

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“…Guidance was required urgently for endoscopic procedures at peak infection, particularly in light of the information on gastrointestinal viral shedding, and only emergency endoscopic procedures were performed with full PPE utilised. Thankfully, updated advice following surveys of clinicians have been produced to guide endoscopists in the post-lockdown period [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

Paediatric surgery and COVID-19: urgent lessons to be learned

Turner

Albolino²,

Morabito

2020

International Journal for Quality in Health Care

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Background The dissemination of scientific data on coronavirus disease 2019 (COVID-19) continually builds but, in April 2020, could not keep up with the spread of the disease. Through technology, surgeons in Italy and the UK, representing both peak and pre-peak infective time zones, were able to communicate so that the urgent lessons on the huge expected demands of care learned in Italy could be brought to the UK in advance. This paper specifically discusses the issues related to paediatric surgery, currently under-reported in the literature. Methods The aim of this paper is to conjoin experience from the field to provide a framework for a safe assessment and treatment of paediatric patients by adopting a systemic approach aimed at reducing the risk of contamination. We reviewed the processes and good practices that were undertaken in contexts of emergency such as in Italy and the UK and then adapted them within the Systems Engineering Initiative for Patient Safety (SEIPS) framework to provide an assessment of how to reorganize the services in order to cope with an unexpected situation. The SEIPS model is the adopted theoretical framework, which allows to analyse the system in its main components with a human factors and ergonomics (HFE) perspective. Results The results introduce some of the good practices and recommendations developed during the emergency in the surgical scenario with a focus on the paediatric patients. They represent the lessons learned from the combination of the little existing evidence of literature and the experience from surgical teams who responded in an impromptu and unrehearsed way. Conclusions Lessons learned from the frontline ‘on the fly’ during COVID-19 emergency should be consolidated and taken into the future. In order to prepare proactively for the next phases and get ahead of the curve of these hospital accesses, there is a need for a risk assessment of the new clinical pathways with a multidisciplinary approach centred on HFE with the adoption of the SEIPS model and an involvement of all the surgical teams.

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Section: Resultsmentioning

confidence: 99%

Paediatric surgery and COVID-19: urgent lessons to be learned

Turner

Albolino²,

Morabito

2020

International Journal for Quality in Health Care

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“…A European survey reported that contact for patients after 7–14 days from endoscopy to inquire about COVID-19 symptoms was done only 28.3% of the time. 29 …”

Section: Discussionmentioning

confidence: 99%

Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

Murcio-Pérez

Zamarripa-Mottú

Andrade-DePaulo

et al. 2021

BMJ Open Gastroenterol

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Background and aimsDigestive endoscopy is considered a high-risk procedure for COVID-19. Recommendations have been made for its practice during the pandemic. This study was conducted to determine adherence to recommendations for endoscopy practice during the COVID-19 pandemic in Latin America (LA).MethodsA survey was conducted of endoscopists from LA consisting of 43 questions for the evaluation of four items: general and sociodemographic features, and preprocedure, intraprocedure and postprocedure aspects.ResultsA response was obtained from 338 endoscopists (response rate 34.5%) across 15 countries in LA. In preprocedure aspects (hand washing, use of face masks for patients, respiratory triage area, training for the placement/removal of personal protective equipment (PPE) and availability of specific area for the placement/removal of PPE), there was adherence in <75%. Regarding postprocedure aspects, 77% (261/338) had reused PPE, mainly the N95 respirator or higher, and this was with a standardised decontamination procedure only in 32% (108/338) of the time. Postprocedure room decontamination was carried out by 47% on >75% of occasions. In relationship to intraprocedure aspects (knowledge of risk and type of endoscopic procedures, use of PPE, airway management in patients and infrastructure), there was adherence in >75% for all the parameters and 78% of endoscopists only performed emergencies or time-sensitive procedures.ConclusionsAdherence to the recommendations for endoscopy practice during the COVID-19 pandemic is adequate in the intraprocedure aspect. However, it is deficient in the preprocedure and postprocedure aspects.

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“…As the COVID-19 pandemic continues to unfold, and with an increased pressure of re-opening endoscopy wards likely to result in an increased number of procedures in COVID-19 patients, 24 it is paramount to continue providing safe and effective treatment, with the aim of minimizing risks to patients and healthcare workers alike. Prospective study cohorts, including a wide variety of procedures performed during the pandemic (including COVID-19 confirmed, suspected and negative patients) could help assess the impact of individual factors such as the perceived risk of contamination and limitations of cumbersome PPE on the technical outcome of the procedures, helping to further adapt our practice in response to these new challenges facing the endoscopist.…”

Section: Discussionmentioning

confidence: 99%

Technical and clinical outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed in patients with COVID-19

Voiosu

Boškoski

et al. 2020

Therap Adv Gastroenterol

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Background: The unprecedented situation caused by the coronavirus disease 2019 (COVID-19) pandemic has profoundly affected endoscopic practice in regard to access, volume, and workflow. We aimed to assess the potential changes in the technical outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures carried out in patients with confirmed SARS-CoV-2 infection. Methods: We conducted an international, multicenter, retrospective, matched case-control study of ERCP procedures carried out in patients with confirmed COVID-19. The main outcome was technical success of the procedure as assessed by the endoscopist, and the secondary outcome was the development of procedure-related adverse events. Each case was matched in a 1:4 ratio with controls extracted from each center’s database in order to identify relevant changes in outcome measures compared with the pre-pandemic era. Results: Eighteen procedures performed in 16 COVID-19 patients [14 men, 65 years (9–82)] and 67 controls were included in the final analysis. Technical success was achieved in 14/18 COVID-19 cases, which was significantly lower as compared with the control group (14/18 versus 64/67, p = 0.034), with an endoscopic reintervention required in 9/18 cases. However, the rate of procedure-related adverse events was low in both groups (1/18 versus 10/67, p = 0.44). On multivariable analysis, COVID-19 status remained the only risk factor for technical failure of the procedure [odds ratio of 19.9 (95% confidence interval 1.4–269.0)]. Conclusions: The COVID-19 pandemic has affected the volume and practice of ERCP, resulting in lower technical success rates without significantly impacting patient safety. Prioritizing cases and following recommendations on safety measures can ensure good outcome with minimal risk in dedicated centers.

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ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey

Abstract: N/A

Cited by 67 publications

References 24 publications

Paediatric surgery and COVID-19: urgent lessons to be learned

Paediatric surgery and COVID-19: urgent lessons to be learned

Adherence to recommendations for endoscopy practice during COVID-19 pandemic in Latin America: how are we doing it?

Technical and clinical outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures performed in patients with COVID-19

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