key: cord-0721903-j72tsof8
authors: Cortegoso Valdivia, Pablo; Le Grazie, Marco; Gaiani, Federica; Decembrino, Francesco; de' Angelis, Gian Luigi
title: Separated pathways in the endoscopy unit for COVID-19 patients
date: 2020-03-27
journal: Gastrointest Endosc
DOI: 10.1016/j.gie.2020.03.3841
sha: 8f2c7fc64a7bc61b4b57a0a97c3bc9e02f889477
doc_id: 721903
cord_uid: j72tsof8

nan

To the Editor:

Recently, Repici et al 1 proposed a model for prevention of COVID-19 infection spread in endoscopy units. The topic is of utmost importance because of the potential for fecal-oral transmission of the SARS-CoV-2, 2 its prolonged persistence on different surfaces, 3 and the fact that, from now on, an increasing number of procedures in patients known to be COVID-19 positive will be performed.

In our tertiary care referral center in northern Italy, in the midst of the viral outbreak, we have developed a model for a specific pathway for these patients in the endoscopy unit. In addition to all the enhanced preventive measures as highlighted in the index article, 1 we propose to set up dedicated spaces for the treatment of virus-positive patients with a separate entrance to the endoscopy unit and exclusive endoscopes, which are used in a specific endoscopy room and subsequently reprocessed in a dedicated adjacent reprocessing room, thus creating an "infected pathway" separated by "noninfected" areas in order to minimize contamination. Endoscope reprocessing is a crucial step in preventing the transmission of pathogens. 4,5 Therefore, the possibility of separating not only patients but also endoscopes, devices, and their reprocessing rooms from the noninfected ones appears of paramount importance, especially in this dramatic time period. It might also be advisable that only selected members of the team are specifically dedicated to this pathway, after proper training on the use of personal protective equipment. We strongly believe that the adjustment of everyday clinical practice with additional measures like those we suggest may have a remarkable effect on the battle against this invisible enemy.

COVID-19) outbreak: what the department of endoscopy should know

COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission

Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoVj-1

Multisociety guideline on reprocessing flexible GI endoscopes: 2016 update

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

All authors disclosed no financial relationships.