Gastrointestinal Endoscopy Practice in Pandemic Conditions

Year 2021, Volume: 11 Issue: 4, 772 - 780, 27.12.2021

Şencan Acar , Mustafa Sadeçolak , Mukaddes Tozlu , Ahmet Tarık Eminler

https://doi.org/10.31832/smj.895992

Abstract

Objective
A novel coronavirus, which is termed COVID-19 or SARS-CoV-2, was declared a pandemic by the WHO since March 2020. Endoscopy is a potential route for infection. Because of this reason, gastroenterology associations around the world recommended the suspension of non-emergency endoscopy. The aim of our study was to investigate the characteristics of the emergency endoscopic procedures performed during the pandemic period and compare with the same period of the previous year.
Material and Methods
Our endoscopy unit is the only center in the city where emergency endoscopic intervention and therapeutic endoscopic procedures are performed on adult patients. Only emergency and urgent endoscopic procedures performed between March 16 and May 18, the period when the pandemic was most intense, were evaluated. The staff in the endoscopy room used full personal protective equipment all endoscopic procedures irrespective of whether or not to test for COVID-19.
Results
96 upper endoscopic (56 of them GI bleeding), 26 lower endoscopic (14 of them GI bleeding, mostly malignancy) and 27 ERCP procedures were carried out. Only one patient that 62 years old male, with a negative typical symptom query, was detected PCR positive for COVID-19 on the same day after the procedure. In the same period in 2019, we had performed 98 upper and 25 lower endoscopies and 99 ERCP for emergency indications.
Conclusion
COVID-19 pandemic process caused extreme changes in endoscopy procedure practice and also indications. All endoscopy units should always be accoutered for the management of emergency endoscopy procedures such as gastrointestinal bleeding.

Keywords

endoscopy, pandemic, hemorrage

Supporting Institution

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Project Number

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Thanks

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Pandemi Koşullarında Gastrointestinal Endoskopi Pratiği

Abstract

Amaç
COVID-19 veya SARS-COV-2 olarak adlandırılan bir yeni Coronavirüs, 2020 yılının Mart ayından bu yana DSÖ tarafından pandemi ilan edildi. Endoskopi de bu enfeksiyon için potansiyel bir yoldur. Bu nedenle, dünyadaki gastroenteroloji dernekleri, acil olmayan endoskopinin durdurulmasını önerdi. Çalışmamızın amacı, pandemi dönemde gerçekleştirilen acil endoskopik prosedürlerin özelliklerini araştırmak ve önceki yılın aynı dönemiyle karşılaştırmaktı.
Gereç ve Yöntemler
Endoskopi ünitemiz, acil endoskopik müdahalenin ve terapötik endoskopik prosedürlerin yetişkin hastalarda yapıldığı şehirdeki tek merkezdir. Sadece 16 Mart-18 Mayıs arasında, salgının en yoğun olduğu dönemindeki acil endoskopik prosedürler değerlendirildi. Endoskopi odasındaki personel, COVID-19 için test edilip edilmemesine bakılmaksızın, tüm endoskopik prosedürleri tam kişisel koruyucu ekipman kullandı.
Bulgular
Toplamda 96 üst endoskopik (56'sının 56'sı GIS kanama nedenli), 26 alt endoskopik (14 tanesi GIS kanama nedenli, çoğunlukla malignite) ve 27 ERCP prosedürü yapıldı. Sadece 62 yaşındaki tipik semptom sorgulaması negatif olan bir hastada prosedürden sonra aynı gün COVID-19 için alınmış olan PCR pozitif olarak tespit edildi. 2019'daki aynı dönemde toplamda 98 üst ve 25 alt endoskopi ile 99 ERCP acil endikasyonlu olarak yapılmıştı.
Sonuç
Covid-19 pandemisi, endoskopi işlemlerinde kısıtlanmış endikasyonlara neden olmuştur. Tüm endoskopi birimleri her zaman gastrointestinal kanama için acil endoskopi prosedürlerinin yönetimi için uygun olmalıdır.

Keywords

endoskopi, pandemi, hemoraji

Project Number

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References

• 1. Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733.
• 2. WHO. Coronavirus disease (COVID-2019) Situation Report 132. Geneva, Switzerland: WHO, 2020.
• 3. World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. https://www.who.int/dg/speeches/detail/whodirectorgeneral- s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
• 4. Daily Coronavirus Report of Turkey. Avaliable at https://covid19.saglik.gov.tr. Accessed, May 31st, 2020. Ankara,Turkey.
• 5. Chiu PWY, Ng SC, Inoue H, et al. Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut. 2020;Epub ahead of print 2 April 2020.
• 6. Endoscopy activity and COVID-19: BSG and JAG guidance. Available at https://www.bsg.org.uk/covid-19-advice/endoscopy-activity-and-covid-19-bsg-and-jag-guidance. Accessed Apr 03, 2020.
• 7. Soetikno R, Teoh AYB, Kaltenbach T, et al. Considerations in performing endoscopy during the COVID-19 pandemic. Gastrointest Endosc. 2020 Mar 27:S0016-5107(20)34033-5.
• 8. Center for Disease Control and Prevention. Protecting healthcare personnel. Available at: https://www.cdc.gov/hai/prevent/ppe.html. Accessed March 23, 2020.
• 9. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382(12):1177-1179.
• 10. Pan Y, Zhang D, Yang P, Poon LLM, Wang Q. Viral load of SARS-CoV-2 in clinical samples. Lancet Infect Dis. 2020;20(4):411-412.
• 11. Gupta S, Shahidi N, Gilroy N, Rex DK, Burgess NG, Bourke MJ. Proposal for the return to routine endoscopy during the COVID-19 pandemic [published online ahead of print, 2020 Apr 28]. Gastrointest Endosc. 2020;S0016-5107(20)34249-8.
• 12. Johnston ER, Habib-Bein N, Dueker JM, et al. Risk of bacterial exposure to the endoscopist's face during endoscopy. Gastrointest Endosc. 2019;89(4):818-824.
• 13. Remuzzi A, Remuzzi G. COVID-19 and Italy: what next?. Lancet. 2020;395(10231):1225-1228.
• 14. Repici A, Maselli R, Colombo M, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know [published online ahead of print, 2020 Mar 14]. Gastrointest Endosc. 2020;S0016-5107(20)30245-5.
• 15. Han J, Wang Y, Zhu L, et al. Preventing the spread of COVID-19 in digestive endoscopy during the resuming period: meticulous execution of screening procedures [published online ahead of print, 2020 Apr 5]. Gastrointest Endosc. 2020;S0016-5107(20)34133-X.
• 16. Castro Filho EC, Castro R, Fernandes FF, Pereira G, Perazzo H. Gastrointestinal endoscopy during the COVID-19 pandemic: an updated review of guidelines and statements from international and national societies [published online ahead of print, 2020 Apr 5]. Gastrointest Endosc. 2020;S0016-5107(20)34132-8.
• 17. Marchese M, Capannolo A, Lombardi L, Di Carlo M, Marinangeli F, Fusco P. Use of a modified ventilation mask to avoid aerosolizing spread of droplets for short endoscopic procedures during coronavirus COVID-19 outbreak [published online ahead of print, 2020 Apr 2]. Gastrointest Endosc. 2020;S0016-5107(20)34131-6.
• 18. Traina M, Amata M, Granata A, Ligresti D, Gaetano B. The C-Cube: an endoscopic solution in the time of COVID-19 [published online ahead of print, 2020 Jun 19]. Endoscopy. 2020;10.1055/a-1190-3462.
• 19. Naseer M, Lambert K, Hamed A, Ali E. Endoscopic advances in the management of non-variceal upper gastrointestinal bleeding: A review. World J Gastrointest Endosc. 2020;12(1):1-16.
• 20. Fujishiro M, Iguchi M, Kakushima N, et al. Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding. Dig Endosc 2016;28:363-378.
• 21. Joint GI Society- Gastroenterology professional society guidance on endoscopic procedures during the COVID-19 pandemic. 2020. Available at https://www.asge.org/home/advanced-education-training/covid-19-asge-updates for members/gastroenterology-professional-society-guidance-on-endoscopic-procedures during-the-covid-19-pandemic. Accessed March 17th, 2020.
• 22. COVID-19: Framework for the Resumption of Endoscopic Activities from the Canadian Association of Gastroenterology. Available at https://www.cag- acg.org/images/publications/CAG-COVID-Endo-Resumption-Final-4-28-20.pdf. Accessed April 28th, 2020.
• 23. Lauro A, Pagano N, Impellizzeri G, Cervellera M, Tonini V. Emergency Endoscopy During the SARS-CoV-2 Pandemic in the North of Italy: Experience from St. Orsola University Hospital-Bologna. Dig Dis Sci. 2020;65(6):1559-1561.