Recommendations of the Spanish Association of Neurogastroenterology and Motility (ASENEM) to restart the activity of gastrointestinal motility laboratories after the state of alarm called due to the COVID-19 pandemic

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for the outbreak of the 2019 coronavirus disease (COVID-19), which is now considered as a pandemic. The prevention strategies adopted have included social distancing measures and the modification, reduction or interruption of a large proportion of routine healthcare activity. This has had a significant impact on the care provided in Gastrointestinal Motility Units. Having passed the peak, in terms of mortality and infections, a gradual reduction in transmission figures has been observed in Spain and other European countries. The risk of reactivation, however, remains high, so it is necessary to have a plan in place that allows healthcare centres to safely resume, for their patients and professionals, instrumental examinations linked to the management of motor pathology. Based on the available scientific evidence and the consensus of a panel of experts, the Spanish Association of Neurogastroenterology and Motility (ASENEM) has drawn up a series of practical recommendations, which have been adapted to the risks inherent in each activity. These include individual protection proposals, as well as organisational and structural measures, which are conceived to allow for the gradual resumption of examinations while minimising the possibility of contagion.

European Society for Neurogastroenterology and Motility recommendations for conducting gastrointestinal motility and function testing in the recovery phase of the COVID‐19 pandemic

“…Nevertheless, many questions on the transmission of the virus and the risk associated with catheter-based or breath test investigations remain uncertain given the emerging nature of the pandemic. This ESNM guidance is based on the collective experiences of the authors at their own institutions and on a few early published reports in the literature (12)(13)(14)(15)(16). Given the evolving nature of our scientific understanding of the…”

“…The recommendations herein are based on submitted manuscripts and published guidelines from several European centres and societies (8,(12)(13)(14)(15). The authors integrated the available recommendations and, after harmonization and review for consensus generation, the current guideline document was drafted and circulated to all members for input and final approval.…”

“…Taken together, given the variable reliability of possible tests and their results in combination with the possible spectrum of symptoms, there is an inherent uncertainty about the patient's COVID-19 status (5,8,10). Therefore, systematic general protective measures and the use of different levels of PPE are recommended for all motility and function testing (8,(12)(13)(14)(15). On the other hand, a combination of absence of risk factors, symptoms and a negative nasopharyngeal swab seems to hold a low risk for contamination during the procedure and may justify less stringent measures to save on limited PPE resources (8,10,41,42).…”

Efficacy of pre‐test questionnaires and PCR on COVID‐19 detection prior to motility examinations

“…Many scientific societies (ESNM, ASENEM, ANMS, and ANMA) have developed guidelines with recommendations on how to perform digestive motility examinations during the pandemic. 2 , 3 , 4 , 5 Although some recommendations are common, because of the shortage of studies evaluating the efficacy of different measures, each guideline has its own particularities. We report our experience using RT‐PCR test and symptom‐based questionnaire before performing a digestive motility examination as a screening test during the third COVID‐19 wave in Catalonia, our referral area.…”