key: cord-0898602-6ge2ihcs
authors: Castro Filho, Elio C.; Castro, Rodolfo; Fernandes, Flavia F.; Pereira, Gustavo; Perazzo, Hugo
title: Gastrointestinal endoscopy during COVID-19 pandemic: an updated review of guidelines and statements from international and national societies
date: 2020-04-05
journal: Gastrointest Endosc
DOI: 10.1016/j.gie.2020.03.3854
sha: 0a1beb9a503c932f467fedfdda1202f8770792b0
doc_id: 898602
cord_uid: 6ge2ihcs

nan

To the Editor We read with great interest the manuscripts published by Repici et al 1 and Soetikno et al 2 in Gastrointestinal Endoscopy on recommendations for endoscopic examinations during the Coronavirus 2019 disease (COVID-19) pandemic. Health care workers (HCW) are at increased risk for COVID-19 because upper GI endoscopy is a high-risk aerosol-generating procedure, 2 and oral-fecal transmission might be a potential route for COVID-19. 3 Recommendations have been changing rapidly and need to be updated, mainly because we are facing a scenario of sustained community transmission of COVID-19 worldwide. 4 To conduct an overview of the recommendations for endoscopic procedures during the COVID-19 pandemic, we assessed electronic sites of international/national societies of gastroenterology/gastrointestinal endoscopy to review the current recommendations up to March 27, 2020. Overall, 93 international/national societies were identified, and 21 of them have elaborated specific recommendations for endoscopy during the COVID-19 pandemic (supplementary material available upon request). A total of 95% recommended temporarily postponing elective/nonurgent procedures; 86% to stratify patients for risk of COVID-19 before the examination (questionnaire of symptoms and/or patient's body temperature); 38% to reduce the number of people who accompany patients; 33% to stimulate self-surveillance of signs/symptoms by HCW, and 19% to contact patients 14 days after the examination to check symptoms (supplementary material available upon request).

All societies recommended the use of personal protective equipment (PPE) during the examination (gloves, mask, goggles, or face shield, gown, and hairnet; double gloves and use of N95 or FFP2/3 masks were recommended in highly suspected or confirmed cases), and 43% recommended that the endoscopy team must be trained in wearing and removing PPE (Table 1 ). There was not any mention of using pre-or postexposure prophylaxis for HCW. All international societies recommended following a standardized reprocessing procedure for flexible endoscopes.

In summary, we validated the recommendations for endoscopy during the COVID-19 pandemic described by our colleagues based on an extensive and updated review of statements of international and national societies of gastroenterology/gastrointestinal endoscopy worldwide. The situation is rapidly evolving, and this guidance might be updated regularly. 

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

Considerations in performing endoscopy during the COVID-19 pandemic

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

European Centre for Disease Prevention and Control. Novel coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEAand the UK-sixth update: European Centre for Disease Prevention and Control