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ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic
We are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy (www.esge.com) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (www.esgena.org) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.
* co-first authors
Article published online:
17 April 2020
© Georg Thieme Verlag KG
Stuttgart · New York
- 1 Guan W-J, Ni Z-Y, Hu Y. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020; DOI: 10.1056/NEJMoa2002032.
- 2 Huang C, Wang Y, Li X. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506
- 3 WHO Director-General’s opening remarks at the media briefing on COVID-19. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
- 4 Download today’s data on the geographic distribution of COVID-19 cases worldwide. European Centre for Disease Prevention and Control; 2020 https://www.ecdc.europa.eu/en/publications-data/download-todays-data-geographic-distribution-covid-19-cases-worldwide
- 5 Remuzzi A, Remuzzi G. COVID-19 and Italy: what next?. The Lancet; 2020 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30627-9/abstract
- 6 Ng K, Poon BH, Kiat Puar TH. et al. COVID-19 and the Risk to Health Care Workers: A Case Report. Ann Intern Med; 2020 https://annals.org/aim/fullarticle/2763329/covid-19-risk-health-care-workers-case-report
- 7 Wang D, Hu B, Hu C. et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. [Epub ahead of print]. JAMA 2020; DOI: 10.1001/jama.2020.1585.
- 8 Wu C, Chen X, Cai Y. et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020
- 9 Young BE, Ong SWX, Kalimuddin S. et al. Epidemiologic Features and Clinical Course of Patients Infected With SARS-CoV-2 in Singapore. JAMA. 2020
- 10 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. [Epub ahead of print]. Gastroenterology 2020; DOI: 10.1053/j.gastro.2020.02.054.
- 11 Tang Jw, Li Y, Eames I. et al. Factors involved in the aerosol transmission of infection and control of ventilation in healthcare premises. J Hosp Infect 2006; 64: 100-114
- 12 Parodi SM, Liu VX. From Containment to Mitigation of COVID-19 in the US. JAMA; 2020 https://jamanetwork.com/journals/jama/fullarticle/2763187
- 13 Repici A, Maselli R, Colombo M. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointestinal Endoscopy; 2020 https://www.giejournal.org/article/S0016-5107(20)30245-5/abstract
- 14 Lui RN, Wong SH, Sánchez-Luna SA. et al. Overview of guidance for endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. [Epub ahead of print]. J Gastroenterol Hepatol 2020; DOI: 10.1111/jgh.15053.
- 15 Sultan S, Lim JK, Altayar O. AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic. Gastroenterology; 2020 https://www.gastrojournal.org/article/S0016-5085(20)30458-3/abstract
- 16 JOINT GASTROENTEROLOGY SOCIETY MESSAGE: COVID-19 Use of Personal Protective Equipment in GI Endoscopy. https://www.asge.org/home/advanced-education-training/covid-19-asge-updates-for-members/joint-gastroenterology-society-message-covid-19-use-of-personal-protective-equipment-in-gi-endoscopy
- 17 Endoscopy activity and COVID-19: BSG and JAG guidance – update 03.04.20. The British Society of Gastroenterology; 2020 https://www.bsg.org.uk/covid-19-advice/endoscopy-activity-and-covid-19-bsg-and-jag-guidance/
- 18 Xiao F, Tang M, Zheng X. et al. Evidence for gastrointestinal infection of SARS-CoV-2. [Epub ahead of print]. Gastroenterology 2020; DOI: 10.1053/j.gastro.2020.02.055.
- 19 Kanne JP. Chest CT Findings in 2019 Novel Coronavirus (2019-nCoV) Infections from Wuhan, China: Key Points for the Radiologist. Radiology 2020; 295: 16-17 DOI: 10.1148/radiol.2020200241.
- 20 Song Y, Liu P, Shi XL. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut; 2020 https://gut.bmj.com/content/early/2020/03/16/gutjnl-2020-320891
- 21 Hamming I, Timens W, Bulthuis MLC. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol 2004; 203: 631-637
- 22 Infection prevention and control and preparedness for COVID-19 in healthcare settings. European Centre for Disease Prevention and Control; 2020 https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-and-preparedness-covid-19-healthcare-settings
- 23 Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. https://www.ecdc.europa.eu/en/publications-data/guidance-wearing-and-removing-personal-protective-equipment-healthcare-settings
- 24 Zhang Y, Zhang X, Liu L. et al. Suggestions for infection prevention and control in digestive endoscopy during current 2019-nCoV pneumonia outbreak in Wuhan, Hubei province, China. Endoscopy 2020; 52: 312-314
- 25 Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125
- 26 Cloth masks and mask sterilisation as options in case of shortage of surgical masks and respirators. European Centre for Disease Prevention and Control; 2020 https://www.ecdc.europa.eu/en/publications-data/cloth-masks-sterilisation-options-shortage-surgical-masks-respirators
- 27 GI Endoscopy Activity and COVID-19: Next steps – Updated 03.04.20. The British Society of Gastroenterology; 2020 https://www.bsg.org.uk/covid-19-advice/gi-endoscopy-activity-and-covid-19-next-steps/
- 28 Beilenhoff U, Biering H, Blum R. et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018. Endoscopy 2018; 50: 1205-1234
- 29 Calderwood AH, Day LW, Muthusamy VR. ASGE Quality Assurance in Endoscopy Committee. et al. ASGE guideline for infection control during GI endoscopy. Gastrointest Endosc 2018; 87: 1167-1179
- 30 Recomendaciones de la SEED: Protección en Unidades de Endoscopia frente al COVID-19. https://wseed.es/images/site/guia_clinica/2020/RecomendacionesSEED_ProteccionUnidadesEndoscopia_Coronavirus.pdf
- 31 Epidémie de COVID-19: recommandations en endoscopie digestive. SFED; 2020 https://www.sfed.org/professionnels/actualites-pro/epidemie-de-covid-19-recommandations-en-endoscopie-digestive
- 32 CDC sequence for putting on personal protective equiment (PPE). https://www.cdc.gov/hai/pdfs/ppe/ppe-sequence.pdf
- 33 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. [Epub ahead of print]. New England Journal of Medicine 2020; DOI: 10.1056/NEJMc2004973.
- 34 Brewster DJ, Chrimes NC, Do TB. et al. Consensus statement: Safe Airway Society principles of airway management and tracheal intubation specific to the COVID-19 adult patient group. Med J Aust; Published online: 16 March 2020.