ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic

Ian M. Gralnek; Cesare Hassan; Ulrike Beilenhoff; Giulio Antonelli; Alanna Ebigbo; Maria Pellisè; Marianna Arvanitakis; Pradeep Bhandari; Raf Bisschops; Jeanin E. Van Hooft; Michal F. Kaminski; Konstantinos Triantafyllou; George Webster; Heiko Pohl; Irene Dunkley; Björn Fehrke; Mario Gazic; Tatjana Gjergek; Siiri Maasen; Wendy Waagenes; Marjon de Pater; Thierry Ponchon; Peter D. Siersema; Helmut Messmann; Mario Dinis-Ribeiro

doi:10.1055/a-1155-6229

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(06): 483-490
DOI: 10.1055/a-1155-6229

Position statement

ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic

Ian M. Gralnek‡^*

¹Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel & Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel

,

Cesare Hassan‡^*

²Nuovo Regina Margherita Hospital, Rome, Italy

,

Ulrike Beilenhoff

³Ulm, Germany

,

Giulio Antonelli

²Nuovo Regina Margherita Hospital, Rome, Italy

,

Alanna Ebigbo

⁴III. Medizinische Klinik Universitätsklinikum Augsburg, Augsburg, Germany

,

Maria Pellisè

⁵Department of Gastroenterology, Hospital Clinic de Barcelona. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS). Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Universitat de Barcelona, Barcelona, Spain

,

Marianna Arvanitakis

⁶Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium

,

Pradeep Bhandari

⁷Portsmouth Hospital NHS Trust, Gastroenterology, Portsmouth, United Kingdom

,

Raf Bisschops

⁸Department of Gastroenterology and Hepatology,Catholic University of Leuven (KUL), TARGID, University, Hospitals Leuven, Leuven, Belgium

,

Jeanin E. Van Hooft

⁹Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands

,

Michal F. Kaminski

¹⁰Department of Cancer Prevention and Department of Oncological Gastroenterology,The Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

,

Konstantinos Triantafyllou

¹¹Hepatogastroenterology Unit, 2nd Department of Internal Medicine - Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece

,

George Webster

¹²Department of Gastroenterology, University College London Hospitals, London, United Kingdom

,

Heiko Pohl

¹³Dartmouth Geisel School of Medicine, Hanover NH, VA Medical Center, Section of Gastroenterology, White River Junction, VT., USA

,

Irene Dunkley

¹⁴North West Anglia NHS Foundation Trust, Hinchingbrooke, United Kingdom

,

Björn Fehrke

¹⁵Inselspital, Bern, Switzerland

,

Mario Gazic

¹⁶General hospital, Bjelovar, Croatia

,

Tatjana Gjergek

¹⁷University Medical Centre, Ljubljana, Slovenia

,

Siiri Maasen

¹⁸Tallinn Healthcare College, Tallin,Estonia

,

Wendy Waagenes

¹⁹Hvidovre Hospital, Copenhagen, Denmark

,

Marjon de Pater

²⁰Amsterdam UMC location AMC, Amsterdam, The Netherlands

,

Thierry Ponchon

²¹Gastroenterology Division, Edouard Herriot Hospital Lyon, France

,

Peter D. Siersema

²²Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands

,

Helmut Messmann

⁴III. Medizinische Klinik Universitätsklinikum Augsburg, Augsburg, Germany

,

Mario Dinis-Ribeiro

²³Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal

› Institutsangaben

Abstract

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.

Volltext

Referenzen

References
1 Guan W-J, Ni Z-Y, Hu Y. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020;
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;
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;
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;
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;
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
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;
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.