Risk-based decision-making related to preprocedural coronavirus disease 2019 testing in the setting of GI endoscopy: management of risks, evidence, and behavioral health economics

Moy, Naomi; Dulleck, Uwe; Shah, Ayesha; Messmann, Helmut; Thrift, Aaron P.; Talley, Nicholas J.; Holtmann, Gerald

doi:10.1016/j.gie.2022.05.023

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…Our data demonstrate the deleterious role of universal preprocedural SARS‐CoV‐2 PCR testing in the recovery of the endoscopic capacity, a practice that may be unnecessarily delaying procedures and diverting resources to activities with marginal, if any, benefits 30 and with contradictory recommendations from different scientific societies 4,31 . The potential effect of this impairment in CRC diagnosis and treatment on mortality should be monitored prospectively.…”

Section: Discussionmentioning

confidence: 88%

Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

Medina‐Prado,

Sala‐Miquel,

Aicart‐Ramos

et al. 2024

Cancer Medicine

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Background and Study AimsOur aim was to determine the impact of the SARS‐CoV‐2 pandemic on the diagnosis and prognosis of colorectal cancer (CRC).Patients and MethodsThis prospective cohort study included individuals diagnosed with CRC between March 13, 2019 and June 20, 2021 across 21 Spanish hospitals. Two time periods were compared: prepandemic (from March 13, 2019 to March 13, 2020) and pandemic (from March 14, 2020 to June 20, 2021, lockdown period and 1 year after lockdown).ResultsWe observed a 46.9% decrease in the number of CRC diagnoses (95% confidence interval (CI): 45.1%–48.7%) during the lockdown and 29.7% decrease (95% CI: 28.1%–31.4%) in the year after the lockdown. The proportion of patients diagnosed at stage I significantly decreased during the pandemic (21.7% vs. 19.0%; p = 0.025). Centers that applied universal preprocedure SARS‐CoV‐2 PCR testing experienced a higher reduction in the number of colonoscopies performed during the pandemic post‐lockdown (34.0% reduction; 95% CI: 33.6%–34.4% vs. 13.7; 95% CI: 13.4%–13.9%) and in the number of CRCs diagnosed (34.1% reduction; 95% CI: 31.4%–36.8% vs. 26.7%; 95% CI: 24.6%–28.8%). Curative treatment was received by 87.5% of patients diagnosed with rectal cancer prepandemic and 80.7% of patients during the pandemic post‐lockdown period (p = 0.002).ConclusionsThe COVID‐19 pandemic has led to a decrease in the number of diagnosed CRC cases and in the proportion of stage I CRC. The reduction in the number of colonoscopies and CRC diagnoses was higher in centers that applied universal SARS‐CoV‐2 PCR screening before colonoscopy. In addition, the COVID‐19 pandemic has affected curative treatment of rectal cancers.

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Section: Discussionmentioning

confidence: 88%

Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

Medina‐Prado,

Sala‐Miquel,

Aicart‐Ramos

et al. 2024

Cancer Medicine

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“…However, it also consumes additional resources such as manpower and costs. After the coronavirus disease 2019 (COVID-19) pandemic, there are restrictions on the implementation of endoscopy due to concerns about the spread of COVID-19 infection [ 24 ]. However, since 3D MACE is used only once without generating aerosol, it can be free from endoscopy mediated infections and disease transmission.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of three-dimensional magnetically assisted capsule endoscopy for upper gastrointestinal and small bowel examination

Oh,

Lee,

Kim

et al. 2024

PLoS ONE

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Background Magnetically assisted capsule endoscopy (MACE) showed the feasibility for upper gastrointestinal examination. To further enhance the performance of conventional MACE, it is necessary to provide quality-improved and three-dimensional images. The aim of this clinical study was to determine the efficacy and safety of novel three-dimensional MACE (3D MACE) for upper gastrointestinal and small bowel examination at once. Methods This was a prospective, single-center, non-randomized, and sequential examination study (KCT0007114) at Dongguk University Ilsan Hospital. Adult patients who visited for upper endoscopy were included. The study protocol was conducted in two stages. First, upper gastrointestinal examination was performed using 3D MACE, and a continuous small bowel examination was performed by conventional method of capsule endoscopy. Two hours later, an upper endoscopy was performed for comparison with 3D MACE examination. The primary outcome was confirmation of major gastric structures (esophagogastric junction, cardia/fundus, body, angle, antrum, and pylorus). Secondary outcomes were confirmation of esophagus and duodenal bulb, accuracy for gastric lesions, completion of small bowel examination, 3D image reconstruction of gastric lesion, and safety. Results Fifty-five patients were finally enrolled. The examination time of 3D MACE was 14.84 ± 3.02 minutes and upper endoscopy was 5.22 ± 2.39 minutes. The confirmation rate of the six major gastric structures was 98.6% in 3D MACE and 100% in upper endoscopy. Gastric lesions were identified in 43 patients during 3D MACE, and 40 patients during upper endoscopy (Sensitivity 0.97). 3D reconstructed images were acquired for all lesions inspected by 3D MACE. The continuous small bowel examination by 3D MACE was completed in 94.5%. 3D MACE showed better overall satisfaction (3D MACE 9.55 ± 0.79 and upper endoscopy 7.75 ± 2.34, p<0.0001). There were no aspiration or significant adverse event or capsule retention in the 3D MACE examination. Conclusions Novel 3D MACE system is more advanced diagnostic modality than the conventional MACE. And it is possible to perform serial upper gastrointestinal and small bowel examination as a non-invasive and one-step test. It would be also served as a bridge to pan-endoscopy.

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“…Dies wurde in einer Kosten-Risiko-Kalkulation unter unterschiedlichen Infektionsszenarios und mit unterschiedlicher Testgenauigkeit der verfügbaren Teststrategien von einer internationalen Arbeitsgruppe in einem Modell berechnet. Das Gesamtrisiko einer Transmission auf das Personal konnte zwar durch eine präprozedurale Teststrategie gesenkt werden, dieser Effekt war für eine „low incidence population“ (Inzidenz < 10/100.000) unter Verwendung von PPE jedoch marginal [ 33 ].…”

Section: Interpretation Der Maßnahmen Im Klinischen Alltag Und Anpass...unclassified

COVID-19 und gastrointestinale Endoskopie –angepasste Strategien im pandemischen Wandel

Mester

Mehrl²,

Dobsch³

et al. 2023

Gastroenterologie

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Im Dezember 2019 begann mit dem Ausbruch der Coronavirus Disease 2019 (COVID-19) eine neue Herausforderung in vielen Bereichen der Medizin und des persönlichen Lebens. Der individuelle Schutz der professionellen Leistungsbringer vor der Infektion wurde zur Sicherung der Leistungsfähigkeit des Gesundheitssystems essenziell. Neue Arbeiten definierten die obere gastrointestinale Endoskopie als aerosolgenerierende Prozedur (AGP), die insbesondere aufgrund des engen Kontakts für das Personal ein erhöhtes Infektionsrisiko darstellt. Da das „severe acute respiratory syndrome coronavirus type 2“ (SARS-CoV-2) in erster Linie durch Aerosole und/oder Tröpfchen übertragen wird, besteht die Notwendigkeit der Verwendung von persönlicher Schutzausrüstung („personal protective equipment“, PPE). Empfehlungen der Leitlinien haben entsprechend früh PPE als infektionspräventive Maßnahmen empfohlen. Die strikte Verwendung von PPE hat sich mit der Erfahrung aus nunmehr 3 Jahren als effektive Präventionsstrategie bewiesen. Mit der Einführung der Vakzinierung gegen SARS-CoV‑2, einer zunehmenden Immunisierung der Bevölkerung und einem sich ändernden pandemischen Infektionsgeschehen haben sich die Anforderungen für endoskopische Abteilungen in den Krankenhäusern und in der ambulanten Versorgung stetig geändert. In der postpandemischen Situation bestehen nur noch geringe Einschränkungen, die die neue „postpandemische Realität“ beeinflussen und die Durchführung endoskopischer Leistungen ohne größere Restriktionen ermöglichen. Die Anpassungen der infektionspräventiven Strategien im Verlauf der Pandemie und die erhobenen wissenschaftlichen Daten mit folgender Anpassung der aktuellen Empfehlungen bis zum heutigen Tag werden in dieser Arbeit zusammengefasst und diskutiert.

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Risk-based decision-making related to preprocedural coronavirus disease 2019 testing in the setting of GI endoscopy: management of risks, evidence, and behavioral health economics

Cited by 6 publications

References 39 publications

Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis

Efficacy and safety of three-dimensional magnetically assisted capsule endoscopy for upper gastrointestinal and small bowel examination

COVID-19 und gastrointestinale Endoskopie –angepasste Strategien im pandemischen Wandel

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