Low risk of COVID-19 transmission in GI endoscopy

Repici, Alessandro; Aragona, Giovanni; Cengia, Gianpaolo; Cantù, P.; Spadaccini, Marco; Maselli, Roberta; Carrara, Sandro; Anderloni, Andrea; Fugazza, Alessandro; Pace, F.; Rösch, Thomas

doi:10.1136/gutjnl-2020-321341

Cited by 146 publications

(155 citation statements)

References 8 publications

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“…Of note, the difficulty accessing diagnostic tests in France at this time explains why only a third of the gastroenterologists who were symptomatic had a PCR test performed. Our infection rate is higher than the 4.3 % (confirmed) infection rate reported in Northern Italy [4], and is possibly explained by a high involvement of the gastroenterologists in the management of COVID-19 patients, and the use of personal protective equipment (PPE), such as masks, by less than half of the endoscopists. This last point could result both ▶ Table 2 Impact of the COVID-19 pandemic on gastrointestinal endoscopy procedures in France and comparison between the responses of those in the highest COVID-19 prevalence areas (North-East of France and Paris area) and those in the rest of the territory.…”

Section: Discussioncontrasting

confidence: 66%

“…Introduction COVID-19 is thought to spread primarily through droplets of saliva, but airborne transmission and fecal excretion have been documented [1,2]. Healthcare professionals in endoscopy are exposed to COVID-19 by the contact of saliva droplets with their face and airways, touch contamination, and contact with patient stools [3,4]. Periendoscopic aerosolized infections have also been reported, placing upper gastrointestinal (GI) endoscopy among the major aerosol-generating procedures [5].…”

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confidence: 99%

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Impact of the COVID-19 pandemic on gastrointestinal endoscopy activity in France

et al. 2020

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Background and study aims: The SARS-CoV-2 pandemic has strongly affected medical activity around the world. We sought to measure the impact of the COVID-19 pandemic on the gastrointestinal endoscopic activity in France. Methods: We performed a web-based survey, including 35 questions on the responders and their endoscopic practice, from March 23rd to March 27th 2020, sent to the 3300 French gastroenterologists practicing endoscopy. Results: 694 (21%) gastrointestinal endoscopists provided analyzable data. 29.4% (204/694) were involved in the management of COVID-19 patients outside the endoscopy departments, and 98.7% (685/694) of the endoscopic procedures were canceled. 12.8% (89/694) of the gastroenterologists reported symptoms compatible with COVID-19 infection, and a positive PCR was recorded in 12/197 (6.1%) vs. 3/497 (0.6%) patients in the high vs. low prevalence areas, p<0.0001. Conclusions: The COVID-19 pandemic led to a major reduction in the volume of gastrointestinal endoscopies performed in France in March 2020. The prolonged limited access to gastrointestinal endoscopy could lead to a delay in the management of patients with gastrointestinal cancers.

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Section: Discussioncontrasting

confidence: 66%

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confidence: 99%

Impact of the COVID-19 pandemic on gastrointestinal endoscopy activity in France

et al. 2020

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“…Although viral RNA has been documented in saliva and feces, whether it is infective is a question of debate, as data from Italy suggest that only one patient out of 851 who underwent endoscopy developed COVID-19 53 and no HCW who came in contact with this patient developed respiratory symptoms. Although this was a retrospective study, it might suggest that endoscopy may be a low-risk procedure for transmission if proper precautions are followed.…”

Section: Gastrointestinal Endoscopy In the Covid-19 Eramentioning

confidence: 99%

Gastrointestinal and Liver Manifestations of COVID-19

Taneja

Mehtani

Chawla

2020

Annals of the National Academy of Medical Sciences (India)

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A novel Coronavirus, SARS-CoV-2 illness, has spread throughout the world after the first case was reported from Wuhan, China, in December 2019. This illness typically causes respiratory symptoms like fever, cough, and shortness of breath, although atypical presentation with gastrointestinal symptoms like abdominal pain, nausea, vomiting, or diarrhea are being increasingly reported. The viral RNA has been detected in saliva and stool of such patients, which raises concerns regarding the risk of transmission during gastrointestinal (GI) endoscopy. Many patients also have liver involvement, with the most common manifestation being deranged liver function tests. This review highlights the symptomatology, mechanism, and histopathology findings of SARS-CoV-2 in GI tract and liver. This review also focuses on implications of COVID-19 in patients afflicted with chronic liver disease and in patients undergoing liver transplantation.

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“…Many studies have been published on COVID-19 in GI endoscopy: infection control measures, observational studies and description of activities during SARS-COV-2 outbreak have been described [1][2][3][4][5][6][7]. Although the studies considered the protection of healthcare workers (HW), only few papers described the percentage of positive cases in HW [1,6,7] and no studies considered the asymptomatic cases in the personnel. However, this point has become crucial because asymptomatic, but positive HW can cause inhospital spreading of the infection and should be considered to calculate the percentage of contaminated workers, especially at the beginning of the so-called phase 2 (gradually re-opening of elective procedures).…”

Section: Introductionmentioning

confidence: 99%

“…The aims of the present study were to calculate the number of COVID-19 patients, the number of positive cases in HW using both nasopharyngeal swabs and serological rapid tests and to obtain the R 0 (contagion's rate) in GI endoscopy in a tertiary referral center as indication of HW exposure. No prespeci ed hypotheses are available because some studies [1] reported the number of positive healthcare workers but not the total number of HW. From the previous studies, a comprehensive exposition of less than 1% to COVID-19 patients can be estimated.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study

Dioscoridi¹,

Carrisi²

2020

Preprint

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Background: Of many descriptive papers about healthcare workers’ (HW) COVID-19 infection, asymptomatic cases have not yet considered. Aims: The present study calculated the numbers of COVID-19 patients afferent to GI endoscopy and the number of positive HW using nasopharyngeal swabs (NS), serological rapid IgM/IgG tests (SRT) and serological quantitative IgG test (SQT).Methods: The study was conducted from 2ndto 30thApril 2020. All the recommended national and international indications on infection control measures were followed. Out of 1227 patients accepted, 1009 were included in the study. 38 HW were tested by NS, SRT and SQT. Descriptive statistical analyses were used to summarize the data.Results: 17 patients were diagnosed COVID-19 positive at NS. 9 patients were known positive at the time of the endoscopy and 8 were diagnosed COVID-19 positive after the procedure. Of the 38 HW, 2 were positive both to NS and SRT with IgM/IgG lines; 7 showed IgG line only at SRT, confirmed by SQT with negative NS. Other 7 HW showed not well-defined line of IgG at SRT, confirmed negative by SQT. The two cases positive to NS and IgM/IgG SRT were asymptomatic. The crude contagion’s rate (R0)was 0.41 and 1.7% of COVID-19 patients caused 19% of positive cases in HW.Conclusions: Not previously diagnosed COVID-19 patients expose HW to additional and incalculable risk of contamination. Association between different tests reduced the variability related to possible confounding factors and increases the accuracy. Since most cases in HW seem to go asymptomatic, large-scale tests using both NS and SRT for both HW and patients should be recommended to minimize the risk of in-hospital infection’s relapses.

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Low risk of COVID-19 transmission in GI endoscopy

Cited by 146 publications

References 8 publications

Impact of the COVID-19 pandemic on gastrointestinal endoscopy activity in France

Impact of the COVID-19 pandemic on gastrointestinal endoscopy activity in France

Gastrointestinal and Liver Manifestations of COVID-19

COVID-19 Exposure Risk of Healthcare Personnel in Digestive Endoscopy: A Prospective Study

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