Impact of enhanced personal protective equipment on colonoscopy performance during the COVID-19 pandemic

Abstract

Background and study aims Using personal protective equipment (PPE) can reduce risk of disease transmission. During the COVID-19 pandemic, enhanced PPE (EPPE) is recommended when performing endoscopy. We aimed to evaluate the impact of EPPE on colonoscopy performance when compared to standard PPE (SPPE).

Patients and methods A review of electronic medical records and endoscopy reports of consecutive patients who underwent colonoscopy during two similar one-month time periods (in 2019 and during the COVID-19 pandemic in 2020) was performed. SPPE was used in 2019 and EPPE was used in 2020. Patient clinical data and procedure-related information were captured and analyzed. The primary outcomes were time to cecum (TTC) and total procedure time. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR). Statistical analysis was performed using STATA v16.1.

Results Two hundred and forty-seven colonoscopy procedures were analyzed. Baseline demographics and indications for colonoscopy of patients in both groups were similar. There were no significant differences in median TTC (10.0 vs 10.0 min, P = 0.524) or total procedure time (22.5 vs 23.0 min, P = 0.946) between colonoscopy performed in SPPE and EPPE. The ADR, PDR and CIR were also similar.

Conclusion Our findings suggest that use of EPPE does not affect colonoscopy performance.

Publication History

Received: 21 April 2020

Accepted: 27 April 2020

Article published online:
02 June 2020

• References

• 1 Repici A, Maselli R, Colombo M. et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.03.019. [Epub ahead of print]
• 2 Soetikno R, Teoh AY, Kaltenbach T. et al. Considerations in performing endoscopy during the COVID-19 pandemic. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.03.3758. [Epub ahead of print]
• 3 British Society of Gastroenterology. BSG/JAG COVID-19 guidance and advice. Available at (Accessed March 27, 2020): https://www.bsg.org.uk/covid-19-advice
• 4 American Society for Gastrointestinal Endoscopy. Joint GI society message: COVID-19 clinical insights for our community of gastroenterologists and gastroenterology care providers. Available from (Accessed March 27, 2020): https://www.asge.org/home/joint-gi-society-message-covid-19
• 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; DOI: 10.1136/gutjnl-2020-321185. [Epub ahead of print]
• 6 Ang TL, Li JW, Vu CK. et al. Chapter of Gastroenterologists professional guidance on risk mitigation for gastrointestinal endoscopy during COVID-19 pandemic in Singapore. Singapore Med J 2020; DOI: 10.11622/smedj.2020050. [Epub ahead of print]
• 7 van Doremalen N, Bushmaker T, Morris DH. et al. Aerosol and surface stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med 2020; DOI: 10.1056/NEJMc2004973. [Epub ahead of print]
• 8 Johnston ER, Habib-Bein N, Dueker JM. et al. Risk of bacterial exposure to the endoscopist's face during endoscopy. Gastrointest Endosc 2019; 89: 818-824
• 9 Wong SH, Lui RN, Sung JJ. Covid-19 and the digestive system. J Gastroenterol Hepatol 2020; DOI: 10.1111/jgh.15047. [Epub ahead of print]
• 10 Kim TH, Kim CH, Shin SD. et al. Influence of personal protective equipment on the performance of life-saving interventions by emergency medical service personnel. SIMULATION 2016; 92: 893-898
• 11 Johnson AT. Respirator masks protect health but impact performance: a review. J Biol Eng 2016; 10: 4
• 12 Palmiero AJ, Symons D, Morgan JW. et al. Speech intelligibility assessment of protective facemasks and air-purifying respirators. J Occup Environ Hyg 2016; 13: 960-968
• 13 Roberge RJ. Face shields for infection control: A review. J Occup Environ Hyg 2016; 13: 235-242
• 14 Waye JD. Difficult colonoscopy. Gastroenterol Hepatol 2013; 9: 676-678