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Review
. 2020 Jul;32(5):715-722.
doi: 10.1111/den.13693. Epub 2020 Jun 3.

COVID-19 and gastrointestinal endoscopies: Current insights and emergent strategies

Abhilash Perisetti  1 , Mahesh Gajendran  2 , Umesha Boregowda  3 , Pardeep Bansal  4 , Hemant Goyal  5
Affiliations
Review

COVID-19 and gastrointestinal endoscopies: Current insights and emergent strategies

Abhilash Perisetti et al. Dig Endosc. 2020 Jul.

Abstract

A new coronavirus emerged in December 2019 in Wuhan city of China, named as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the disease was called coronavirus disease-2019 (COVID-19). The infection due to this virus spread exponentially throughout China and then spread across >205 nations, including the United States (US). Gastrointestinal (GI) endoscopies are routinely performed in the US and globally. Previous reports of isolated infection outbreaks were reported with endoscopes acting as potential vectors. While multidrug-resistant organisms have been reported to be spread by endoscopes, few cases of viruses such as hepatitis B and C are noted in the literature. COVID-19 is predominately spread by droplet transmission, although recent evidence has showed that shedding in feces and feco-oral transmission could also be possible. It is unclear if COVID-19 could be transmitted by endoscopes, but it could theoretically happen due to contact with mucous membranes and body fluids. GI endoscopies involve close contact with oral and colonic contents exposing endoscopy staff to respiratory and oropharyngeal secretions. This can increase the risk of contamination and contribute to virus transmission. Given these risks, all major GI societies have called for rescheduling elective non-urgent procedures and perform only emergent or urgent procedures based on the clinical need. Furthermore, pre-screening of all individuals prior to endoscopy is recommended. This article focuses on the risk of COVID-19 transmission by GI shedding, the potential role of endoscopes as a vector of this novel virus, including transmission during endoscopies, and prevention strategies including deferral of elective non-urgent endoscopy procedures.

Keywords: COVID-19; SARS-CoV-2; coronavirus; endoscopy; pandemic.

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Conflict of interest statement

Authors declare no conflicts of interest for this article.

Figures

Figure 1
Figure 1
Major global viral outbreaks in the last 20 years. [Information sources: Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO)].
Figure 2
Figure 2
Timeline of the global spread of COVID‐19. [Information sources: Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO)].
See this image and copyright information in PMC

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