Practice of digestive endoscopy in the COVID-19 pandemic era

Abstract

Abstract
Introduction : Health care personal working in digestive endoscopy unit is exposed to the SARS-CoV-2 risk of transmission via aerosols and contact with contaminated surfaces.
Aim : To establish recommendations for the practice of digestive endoscopy during the different phases of the COVID-19 epidemic, applicable for our country in a context of limited resources, expensive equipment and absence of mass screening.
Methods : A review of the medical literature was performed using the Medline® database, using various combinations of the following keywords : SARS-CoV-2, coronavirus, COVID-19, pandemics, endoscopy, digestive system endoscopy, Real-time polymerase chain reaction, infection control, personal protective equipment. The more relevant articles were selected. In a second time the digestive endoscopy club issued recommendations taking into account local conditions.
Results : In order to reduce the virus transmission risk, a stratification of the patient’s infection risk and the urgency of endoscopic examinations is recommended before the procedure. During phase 4 of the epidemic, all patients should be considered at high risk of infection, only urgent or high priority endoscopies are performed, and enhanced personal protective equipment must be worn in the endoscopy and disinfection rooms. During the other phases, some measures must be respected depending on the epidemic period, and the patient’s infection risk.
Conclusion: The application of the proposed recommendations will allow staff in digestive endoscopy units to work safely and prevent virus transmission to the patients during the COVID-19 epidemic.