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Liu T, Peng C, Hsu F, Chang L, Wang H, Chang W. Setting up a three‐stage pre‐endoscopy triage during the coronavirus disease 2019 pandemic: A multicenter observational study. DEN OPEN 2023; 3:e159. [PMID: 35959099 PMCID: PMC9360760 DOI: 10.1002/deo2.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/14/2022] [Accepted: 07/20/2022] [Indexed: 01/08/2023]
Abstract
Objectives Between May and July 2021, the coronavirus disease 2019 (COVID‐19) pandemic led to a sharp surge in community transmission in Taiwan. We present a three‐stage restructuring process of pre‐endoscopy triage at the beginning of the pandemic, which can support urgent endoscopic procedures while protecting endoscopy staff. Methods The pre‐endoscopy triage framework was set up with three checkpoints at the hospital entrance, outpatient department, and endoscopy unit, with a specific target patient population and screening methods. Relevant data included the number of endoscopic procedures performed, outpatient department visits, and performing screening methods such as temperature measurement, travel, occupation, contact, and clustering history checking, polymerase chain reaction assay, and rapid antigen test. Results Forehead temperature measurement and verification of travel, occupation, contact, and clustering history provided rapid, easy, and early mass screening of symptomatic patients at the hospital entrance. During the pandemic, outpatient department visits and endoscopic procedures decreased by 37% and 64%, respectively. The pre‐endoscopy screening methods used displayed regional variations in COVID‐19 prevalence. Among 16 endoscopy units with a community prevalence of ≥ 31.04 cases per 100,000 residents, 12 (75%) used polymerase chain reaction assay and four (25%) used rapid antigen test to identify asymptomatic patients before endoscopy. Of 6540 pre‐endoscopy screening patients, 15 (0.23%) tested positive by laboratory testing. No endoscopy‐related nosocomial COVID‐19 infections were reported during the pandemic. Conclusions We present a three‐stage pre‐endoscopy triage based on the local laboratory capacity, medical resources, and community prevalence. These measures could be useful during the COVID‐19 pandemic.
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Affiliation(s)
- Tao‐Chieh Liu
- Department of Internal MedicineDivision of GastroenterologyTri‐Service General Hospital, National Defense Medical CenterTaipeiTaiwan
| | - Chen‐Ling Peng
- Department of Integrated Diagnostics and Therapeutics National Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan
| | - Fang‐Yu Hsu
- Department of Hepatology and GastroenterologyChang Gung Memorial Hospital, Linkou Medical CenterTaipeiTaiwan
| | - Li‐Chun Chang
- Department of Internal MedicineDivision of Gastroenterology and HepatologyNational Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan
| | - Hsiu‐Po Wang
- Department of Internal MedicineDivision of Gastroenterology and HepatologyNational Taiwan University Hospital, National Taiwan University College of MedicineTaipeiTaiwan
| | - Wei‐Kuo Chang
- Department of Internal MedicineDivision of GastroenterologyTri‐Service General Hospital, National Defense Medical CenterTaipeiTaiwan
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COVID-19 und gastrointestinale Endoskopie –angepasste Strategien im pandemischen Wandel. DIE GASTROENTEROLOGIE 2023. [PMCID: PMC9979133 DOI: 10.1007/s11377-023-00678-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Im Dezember 2019 begann mit dem Ausbruch der Coronavirus Disease 2019 (COVID-19) eine neue Herausforderung in vielen Bereichen der Medizin und des persönlichen Lebens. Der individuelle Schutz der professionellen Leistungsbringer vor der Infektion wurde zur Sicherung der Leistungsfähigkeit des Gesundheitssystems essenziell. Neue Arbeiten definierten die obere gastrointestinale Endoskopie als aerosolgenerierende Prozedur (AGP), die insbesondere aufgrund des engen Kontakts für das Personal ein erhöhtes Infektionsrisiko darstellt. Da das „severe acute respiratory syndrome coronavirus type 2“ (SARS-CoV-2) in erster Linie durch Aerosole und/oder Tröpfchen übertragen wird, besteht die Notwendigkeit der Verwendung von persönlicher Schutzausrüstung („personal protective equipment“, PPE). Empfehlungen der Leitlinien haben entsprechend früh PPE als infektionspräventive Maßnahmen empfohlen. Die strikte Verwendung von PPE hat sich mit der Erfahrung aus nunmehr 3 Jahren als effektive Präventionsstrategie bewiesen. Mit der Einführung der Vakzinierung gegen SARS-CoV‑2, einer zunehmenden Immunisierung der Bevölkerung und einem sich ändernden pandemischen Infektionsgeschehen haben sich die Anforderungen für endoskopische Abteilungen in den Krankenhäusern und in der ambulanten Versorgung stetig geändert. In der postpandemischen Situation bestehen nur noch geringe Einschränkungen, die die neue „postpandemische Realität“ beeinflussen und die Durchführung endoskopischer Leistungen ohne größere Restriktionen ermöglichen. Die Anpassungen der infektionspräventiven Strategien im Verlauf der Pandemie und die erhobenen wissenschaftlichen Daten mit folgender Anpassung der aktuellen Empfehlungen bis zum heutigen Tag werden in dieser Arbeit zusammengefasst und diskutiert.
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Wang CW, Mclean I R, Cheng YW, Kim S, Terdiman J, Kathpalia P, Beck KR. Racial Disparities in Endoscopy Cancellations During the COVID-19 Pandemic. Dig Dis Sci 2023; 68:729-735. [PMID: 35732970 PMCID: PMC9216287 DOI: 10.1007/s10620-022-07575-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/20/2022] [Indexed: 12/09/2022]
Abstract
INTRODUCTION The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including elective endoscopy. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic. METHODS Medical charts were reviewed for adults who cancelled an outpatient endoscopic procedure from 5/2020 to 8/2020. The association of patient characteristics with cancellation of endoscopy due to COVID-19 was assessed using logistic regression. RESULTS There were 652 endoscopy cancelations with 211 (32%) due to COVID-19, 384 (59%) due to non-COVID reasons, and 57 (9%) undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On adjusted analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.04, 95% CI 1.07-3.88, p = 0.03), while patients undergoing EGD (OR 0.56, 95% CI 0.31-0.99, p = 0.05) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p = 0.001) had lower odds of cancellation. The odds of cancelling due to COVID-19 testing logistics was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p = 0.05) and patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p = 0.02). CONCLUSION Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to logistics of obtaining pre-endoscopy COVID-19 testing. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.
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Affiliation(s)
- Connie W. Wang
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
| | - Richard Mclean I
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
| | - Yao-Wen Cheng
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
| | - Stephanie Kim
- grid.266102.10000 0001 2297 6811University of California San Francisco School of Medicine, San Francisco, CA USA
| | - Jonathan Terdiman
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
| | - Priya Kathpalia
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
| | - Kendall R. Beck
- grid.266102.10000 0001 2297 6811Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, 513 Parnassus Avenue, Room S-357, San Francisco, CA 94143 USA
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Passi M, Stadnytskyi V, Anfinrud P, Koh C. Visualizing endoscopy-generated aerosols with laser light scattering (with videos). Gastrointest Endosc 2022; 96:1072-1077. [PMID: 35932817 PMCID: PMC9596173 DOI: 10.1016/j.gie.2022.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Upper GI endoscopy is speculated to be an aerosol-generating procedure (AGP). Robust evidence exists for aerosol transmission of severe acute respiratory syndrome coronavirus 2. The quality of data available confirming aerosol generation during GI endoscopy is limited. We aimed to objectively demonstrate that GI endoscopy is an AGP and illustrate the mechanism by which the greatest risk for aerosolization of droplets during endoscopy may occur. METHODS Aerosolized droplets generated during insertion and withdrawal of an endoscope and with passage of various tools through the endoscopic working channel using 2 experimental apparatuses modeling an upper GI tract (ie, a fluid-filled tube and a lamb esophagus) were qualitatively assessed by laser light scattering. RESULTS Insertion and withdrawal of the upper endoscope into the upper GI tract models generated numerous aerosolized particles. A large number of brightly scattering particles were observed at the site of insertion and withdrawal of the endoscope. Passage of a cytology brush, biopsy forceps, and hemostatic clip through the working endoscope channel also generated aerosolized particles but in fewer numbers. There was no significant variation in quantity or brightness of droplets generated on testing different biopsy valve cap models or when suctioning fluid with an open versus closed biopsy valve cap. These results were reproducible over several trials. CONCLUSIONS We illustrate in an objective manner that upper GI endoscopy is an AGP. These findings may have implications for transmission of infectious airborne pathogens outside of severe acute respiratory syndrome coronavirus 2 and can help to inform guidance on appropriate personal protective equipment use and other measures for transmission risk mitigation during GI endoscopy.
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Affiliation(s)
- Monica Passi
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Valentyn Stadnytskyi
- Labratory of Chemical Physics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Philip Anfinrud
- Labratory of Chemical Physics, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Christopher Koh
- Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA,Reprint requests: Christopher Koh, MD, MHSc, FACP, FAASLD, Acting Clinical Director, Division of Intramural Research, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, 10 Center Dr, Bldg 10, Rm 9C-101, Bethesda, MD 20892
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Hann A, Flemming S, Reimer S, Groneberg K, Kudlich T, Germer CT, Meining A. Impact of pre-procedural testing on SARS-CoV-2 transmission to endoscopy staff. Gut 2022; 71:2167-2169. [PMID: 35798374 PMCID: PMC9554071 DOI: 10.1136/gutjnl-2022-327053] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/29/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Alexander Hann
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Sven Flemming
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Stanislaus Reimer
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Kaja Groneberg
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Theodor Kudlich
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany
| | - Alexander Meining
- Department of Internal Medicine II, Gastroenterology, University Hospital Würzburg, Würzburg, Germany
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Molinaro C, Bénéfice M, Gorlas A, Da Cunha V, Robert HML, Catchpole R, Gallais L, Forterre P, Baffou G. Life at high temperature observed in vitro upon laser heating of gold nanoparticles. Nat Commun 2022; 13:5342. [PMID: 36097020 PMCID: PMC9468142 DOI: 10.1038/s41467-022-33074-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Thermophiles are microorganisms that thrive at high temperature. Studying them can provide valuable information on how life has adapted to extreme conditions. However, high temperature conditions are difficult to achieve on conventional optical microscopes. Some home-made solutions have been proposed, all based on local resistive electric heating, but no simple commercial solution exists. In this article, we introduce the concept of microscale laser heating over the field of view of a microscope to achieve high temperature for the study of thermophiles, while maintaining the user environment in soft conditions. Microscale heating with moderate laser intensities is achieved using a substrate covered with gold nanoparticles, as biocompatible, efficient light absorbers. The influences of possible microscale fluid convection, cell confinement and centrifugal thermophoretic motion are discussed. The method is demonstrated with two species: (i) Geobacillus stearothermophilus, a motile thermophilic bacterium thriving around 65 °C, which we observed to germinate, grow and swim upon microscale heating and (ii) Sulfolobus shibatae, a hyperthermophilic archaeon living at the optimal temperature of 80 °C. This work opens the path toward simple and safe observation of thermophilic microorganisms using current and accessible microscopy tools. Studying microorganisms at high temperatures is challenging on conventional optical microscopes. Here, the authors introduce the concept of microscale laser heating over the full field of view by using gold nanoparticles as light absorbers, and study thermophile species up to 80 °C.
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Appropriateness of routine pre-endoscopic SARS-CoV-2 screening with RT-PCR in asymptomatic individuals and its impact on delayed diagnosis. GASTROENTEROLOGÍA Y HEPATOLOGÍA 2022; 46:274-281. [PMID: 35964808 PMCID: PMC9371764 DOI: 10.1016/j.gastrohep.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/03/2022] [Accepted: 07/21/2022] [Indexed: 12/27/2022]
Abstract
Aims Patients and methods Results Conclusions
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Sahin T, Simsek C, Balaban HY. Practical points that gastrointestinal fellows should know in management of COVID-19. World J Clin Cases 2022; 10:5133-5145. [PMID: 35812670 PMCID: PMC9210885 DOI: 10.12998/wjcc.v10.i16.5133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/31/2021] [Accepted: 04/21/2022] [Indexed: 02/06/2023] Open
Abstract
Pandemics obligate providers to transform their clinical practice. An extensive effort has been put to find out feasible approaches for gastrointestinal diseases and also to manage coronavirus disease 2019 (COVID-19) related gastrointestinal conditions. Diarrhea, hepatitis, and pancreatitis can be seen in the COVID-19 course. Endoscopic procedures increase the risk of contamination for medical staff and patients despite precautions, therefore indications should be tailored to balance risks vs benefits. Furthermore, whether the immunosupression in inflammatory bowel diseases, liver transplantation, and autoimmune liver diseases increases COVID-19 related risks and how to modify immunosupression are topics of ongoing debate. This review aims to provide most up to date practical approaches that a gastrointestinal fellow should be aware on the problems and management of gastrointestinal and hepatobiliary diseases during the COVID-19 pandemic.
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Affiliation(s)
- Tevhide Sahin
- Department of Gastroenterology, Hacettepe University, Faculty of Medicine, Ankara 06100, Turkey
| | - Cem Simsek
- Department of Gastroenterology, Hacettepe University, Faculty of Medicine, Ankara 06100, Turkey
| | - Hatice Yasemin Balaban
- Department of Gastroenterology, Hacettepe University, Faculty of Medicine, Ankara 06100, Turkey
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Effect of enhanced personal protective equipment on colonoscopy performance and pain linked to procedure during the COVID-19 pandemic. Acta Gastroenterol Belg 2022; 85:269-275. [DOI: 10.51821/85.2.9621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background and study aim: During the COVID-19 pandemic, the use of standard personal protective equipment (SPPE) reduces transmission risks during endoscopic procedures. Our aim was to assess the effect of enhanced personal protective equipment (EPPE) on colonoscopy performance and pain linked to the procedure compared with SPPE.
Patients and methods: During two similar periods with three- month duration (in 2019 and in 2020 during the COVID-19 pandemic), electronic medical records and colonoscopy reports were investigated for sequential patients undergoing colonoscopy. SPPE was used in 2019 and EPPE in 2020. The patients’ clinical data and information related to the procedure were collected and analyzed. Primary outcomes were the duration to intubate the cecum, total procedure duration and patient pain score at the end of the procedure. Secondary outcomes were adenoma detection rate (ADR), polyp detection rate (PDR) and cecal intubation rate (CIR).
Results: A total of 426 patients with colonoscopy performed were analyzed. The demographic features and indications for colonoscopy were similar for patients in both groups. The EPPE group had higher values for the parameters assessed as primary endpoints of cecal intubation time, withdrawal time, total procedure time and pain at the end of the procedure compared to the SPPE group and the differences were statistically significant. Conclusion: Our findings show that though the use of EPPE negatively affected colonoscopy performance and patient pain at the end of the procedure, it had no effect on the colonoscopy quality indices such as ADR, PDR and CIR.
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Eliwa A, Osman OM, Helal A, Mohamed AS, ElFayoumie M, Eldamarawy R, Mostafa S, Elsharkawy A, Makboul KS, Elshennawy SI, Abdelhady M, Elbahrawy A. COVID-19 screening before gastrointestinal procedures. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
In March 2020, the World Health Organization declared coronavirus 2019 (COVID-19) a global pandemic. We aimed to assess the ability of COVID-19 screening to detect preprocedural infection at the gastrointestinal units. One hundred and three patients indicated for gastrointestinal tract interventional procedures were included. All patients surveyed for COVID-19-related symptoms and COVID-19 rapid IgM/IgG antibodies. Symptomatic and COVID-19 antibody-positive patients further tested for COVID-19 reverse transcriptase by polymerase chain reaction (RT-PCR). All patients contacted, 14 days after the procedure and asked about the possible development of COVID-19. All health care workers (HCWs) (n=18) were screened weekly for COVID-19-related symptoms.
Results
The mean age was 46.11 ± 17.16 years of them 58.25% were males. 2.9% patients had COVID-19-related symptoms and 97.1% were asymptomatic. All symptomatic patients tested positive for COVID-19 IgM antibody and RT-PCR. Among asymptomatic patients 23% had positive COVID-19 antibodies, of them 56.5%patients had positive RT-PCR. One HCW developed COVID-19 during the study. None of the included patients developed new onset of COVID-19 infection, two weeks after the procedure.
Conclusion
COVID-19 antibody test may be a reasonable preprocedural screening method for low-income countries and COVID-19 RT-PCR screening for symptomatic patients and those with positive COVID-19 antibody test.
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Alhalabi M, Eddin KA, Ali F, Abbas A. SARS-CoV-2 (COVID-19) pneumonia patient treated with two doses of infliximab within 2 weeks for acute severe ulcerative colitis: A case report. Medicine (Baltimore) 2022; 101:e28722. [PMID: 35089243 PMCID: PMC8797526 DOI: 10.1097/md.0000000000028722] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 02/07/2023] Open
Abstract
RATIONALE The ongoing coronavirus pandemic has caused severe acute respiratory syndrome, posing a significant challenge for patients receiving immunotherapy for immune-mediated inflammatory diseases. As of January 2022, immunosuppressants such as tumor necrosis factor inhibitors (anti-TNFα) and azathioprine are inadvisable for an infectious disease caused by the SARS-CoV-2 virus (COVID-19). We continued infliximab as a second induction dose nine days after the onset of COVID-19 symptoms in a patient with acute severe ulcerative colitis. PATIENT CONCERNS We report the case of a 34-year-old male with 6 to 8 times bloody diarrhea, fever, and cramping abdominal pain. Ulcerative colitis was diagnosed 6 months earlier and treated with mesalamine 80 mg/kg/day and azathioprine 2.5 mg/kg/day. The patient had never undergone surgery before. Sigmoidoscopy revealed multiple ulcerations and spontaneous bleeding, and the colon samples tested negative for cytomegalovirus and Clostridium difficile. However, intravenous corticosteroids did not induce remission. A nasopharyngeal swab tested positive for SARS-CoV-2. DIAGNOSIS Acute severe ulcerative colitis and SARS-CoV-2 (COVID-19) pneumonia. INTERVENTIONS The second loading dose of infliximab was administered nine days after the diagnosis of COVID-19. OUTCOME The patient completed infliximab induction at a dose of 5 mg/kg at weeks 0, 2, and 6, with no complications. LESSONS It is unclear whether anti-TNF-α treatment improves or deteriorates COVID-19 patient outcomes, and this case demonstrates that infliximab can be used safely. Current guidelines make a weak recommendation to avoid using anti-TNFα agents in the presence of acute COVID-19 infection. There is an urgent need for research on biologics therapy.
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Muñoz J, Pumera M. 3D-Printed COVID-19 immunosensors with electronic readout. CHEMICAL ENGINEERING JOURNAL (LAUSANNE, SWITZERLAND : 1996) 2021; 425:131433. [PMID: 34393616 PMCID: PMC8349461 DOI: 10.1016/j.cej.2021.131433] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/30/2021] [Accepted: 07/18/2021] [Indexed: 05/09/2023]
Abstract
3D printing technology has brought light in the fight against the COVID-19 global pandemic event through the decentralized and on-demand manufacture of different personal protective equipment and medical devices. Nonetheless, since this technology is still in an early stage, the use of 3D-printed electronic devices for antigen test developments is almost an unexplored field. Herein, a robust and general bottom-up biofunctionalization approach via surface engineering is reported aiming at providing the bases for the fabrication of the first 3D-printed COVID-19 immunosensor prototype with electronic readout. The 3D-printed COVID-19 immunosensor was constructed by covalently anchoring the COVID-19 recombinant protein on a 3D-printed graphene-based nanocomposite electrode surface. The electrical readout relies on impedimetrically monitoring changes at the electrode/electrolyte interface after interacting with the monoclonal COVID-19 antibody via competitive assay, fact that hinders the redox conversion of a benchmark redox marker. Overall, the developed 3D-printed system exhibits promising electroanalytical capabilities in both buffered and human serum samples, displaying an excellent linear response with a detection limit at trace levels (0.5 ± 0.1 μg·mL-1). Such achievements demonstrate advantage of light-of-speed distribution of 3D printing datafiles with localized point-of-care low-cost printing and bioelectronic devices to help contain the spread of emerging infectious diseases such as COVID-19. This technology is applicable to any post-COVID-19 SARS diseases.
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Affiliation(s)
- Jose Muñoz
- Future Energy and Innovation Laboratory, Central European Institute of Technology, Brno University of Technology (CEITEC-BUT), Brno 61600, Czech Republic
| | - Martin Pumera
- Future Energy and Innovation Laboratory, Central European Institute of Technology, Brno University of Technology (CEITEC-BUT), Brno 61600, Czech Republic
- Department of Medical Research, China Medical University Hospital, China Medical University, No. 91 Hsueh-Shih Road, Taichung, Taiwan
- 3D Printing & Innovation Hub, Department of Food Technology, Mendel University in Brno, Zemedelska 1, Brno CZ-613 00, Czech Republic
- Department of Chemical and Biomolecular Engineering, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
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Dronina J, Samukaite-Bubniene U, Ramanavicius A. Advances and insights in the diagnosis of viral infections. J Nanobiotechnology 2021; 19:348. [PMID: 34717656 PMCID: PMC8556785 DOI: 10.1186/s12951-021-01081-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022] Open
Abstract
Viral infections are the most common among diseases that globally require around 60 percent of medical care. However, in the heat of the pandemic, there was a lack of medical equipment and inpatient facilities to provide all patients with viral infections. The detection of viral infections is possible in three general ways such as (i) direct virus detection, which is performed immediately 1-3 days after the infection, (ii) determination of antibodies against some virus proteins mainly observed during/after virus incubation period, (iii) detection of virus-induced disease when specific tissue changes in the organism. This review surveys some global pandemics from 1889 to 2020, virus types, which induced these pandemics, and symptoms of some viral diseases. Non-analytical methods such as radiology and microscopy also are overviewed. This review overlooks molecular analysis methods such as nucleic acid amplification, antibody-antigen complex determination, CRISPR-Cas system-based viral genome determination methods. Methods widely used in the certificated diagnostic laboratory for SARS-CoV-2, Influenza A, B, C, HIV, and other viruses during a viral pandemic are outlined. A comprehensive overview of molecular analytical methods has shown that the assay's sensitivity, accuracy, and suitability for virus detection depends on the choice of the number of regions in the viral open reading frame (ORF) genome sequence and the validity of the selected analytical method.
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Affiliation(s)
- Julija Dronina
- Laboratory of Nanotechnology, Department of Functional Materials and Electronics, Center for Physical Sciences and Technology, Sauletekio av. 3, Vilnius, Lithuania
- Department of Physical Chemistry, Faculty of Chemistry and Geoscience, Vilnius University, Naugarduko str. 24, 03225, Vilnius, Lithuania
| | - Urte Samukaite-Bubniene
- Department of Physical Chemistry, Faculty of Chemistry and Geoscience, Vilnius University, Naugarduko str. 24, 03225, Vilnius, Lithuania
| | - Arunas Ramanavicius
- Department of Physical Chemistry, Faculty of Chemistry and Geoscience, Vilnius University, Naugarduko str. 24, 03225, Vilnius, Lithuania.
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Chua TY, Kyanam Kabir Baig KR, Leung FW, Ashat M, Jamidar PA, Mulki R, Singh A, Yu JX, Lightdale JR. GIE Editorial Board top 10 topics: advances in GI endoscopy in 2020. Gastrointest Endosc 2021; 94:441-451. [PMID: 34147512 DOI: 10.1016/j.gie.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 06/14/2021] [Indexed: 02/08/2023]
Abstract
The American Society for Gastrointestinal Endoscopy's Gastrointestinal Endoscopy Editorial Board reviewed a systematic literature search of original endoscopy-related articles published during 2020 in Gastrointestinal Endoscopy and 10 other high-impact medical and gastroenterology journals. Votes from each individual board member were tallied to identify a consensus list of the 10 most significant topic areas in GI endoscopy over the calendar year of study using 4 criteria: significance, novelty, impact on national health, and impact on global health. The 10 areas identified were as follows: artificial intelligence in endoscopy, coronavirus disease 2019 and GI practice, third-space endoscopy, lumen-apposing metal stents, single-use duodenoscopes and other disposable equipment, endosonographic needle technology and techniques, endoscopic closure devices, advances in GI bleeding management, improvements in polypectomy techniques, and bariatric endoscopy. Each board member contributed a summary of important articles relevant to 1 to 2 topic areas, leading to a collective summary that is presented in this document of the "top 10" endoscopic advances of 2020.
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Affiliation(s)
- Tiffany Y Chua
- Division of Digestive Diseases, Harbor-University of California Los Angeles, Torrance, California, USA
| | - Kondal R Kyanam Kabir Baig
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Felix W Leung
- VA Sepulveda Ambulatory Care Center, North Hills, California, USA
| | - Munish Ashat
- Division of Gastroenterology and Hepatology, Indiana School of Medicine, Indianapolis, Indiana, USA
| | - Priya A Jamidar
- Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ramzi Mulki
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ajaypal Singh
- Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | - Jessica X Yu
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jenifer R Lightdale
- Division of Pediatric Gastroenterology and Nutrition, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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15
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Sultan S, Siddique SM, Singh S, Altayar O, Caliendo AM, Davitkov P, Feuerstein JD, Kaul V, Lim JK, Mustafa RA, Falck-Ytter Y, Inadomi JM. AGA Rapid Review and Guideline for SARS-CoV2 Testing and Endoscopy Post-Vaccination: 2021 Update. Gastroenterology 2021; 161:1011-1029.e11. [PMID: 34029569 PMCID: PMC8139430 DOI: 10.1053/j.gastro.2021.05.039] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This guideline provides updated recommendations on the role of preprocedure testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) in individuals undergoing endoscopy in the post-vaccination period and replaces the prior guideline from the American Gastroenterological Association (AGA) (released July 29, 2020). Since the start of the pandemic, our increased understanding of transmission has facilitated the implementation of practices to promote patient and health care worker (HCW) safety. Simultaneously, there has been increasing recognition of the potential harm associated with delays in patient care, as well as inefficiency of endoscopy units. With widespread vaccination of HCWs and the general population, a re-evaluation of AGA's prior recommendations was warranted. In order to update the role of preprocedure testing for SARS-CoV2, the AGA guideline panel reviewed the evidence on prevalence of asymptomatic SARS-CoV2 infections in individuals undergoing endoscopy; patient and HCW risk of infections that may be acquired immediately before, during, or after endoscopy; effectiveness of COVID-19 vaccine in reducing risk of infections and transmission; patient and HCW anxiety; patient delays in care and potential impact on cancer burden; and endoscopy volumes. The panel considered the certainty of the evidence, weighed the benefits and harms of routine preprocedure testing, and considered burden, equity, and cost using the Grading of Recommendations Assessment, Development and Evaluation framework. Based on very low certainty evidence, the panel made a conditional recommendation against routine preprocedure testing for SARS-CoV2 in patients scheduled to undergo endoscopy. The panel placed a high value on minimizing additional delays in patient care, acknowledging the reduced endoscopy volumes, downstream impact on delayed cancer diagnoses, and burden of testing on patients.
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Affiliation(s)
- Shahnaz Sultan
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, Minneapolis, Minnesota.
| | - Shazia M Siddique
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Siddharth Singh
- Division of Gastroenterology, University of California San Diego, La Jolla, California
| | - Osama Altayar
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri
| | - Angela M Caliendo
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Perica Davitkov
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Joseph D Feuerstein
- Division of Gastroenterology and Center for Inflammatory Bowel Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Vivek Kaul
- Division of Gastroenterology and Hepatology at the University of Rochester Medical Center, Rochester, New York
| | - Joseph K Lim
- Yale Liver Center and Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - John M Inadomi
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
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16
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Tan X, Guo J, Chen Z, Königsrainer A, Wichmann D. Systematic review and meta-analysis of clinical outcomes of COVID-19 patients undergoing gastrointestinal endoscopy. Therap Adv Gastroenterol 2021; 14:17562848211042185. [PMID: 34484425 PMCID: PMC8408897 DOI: 10.1177/17562848211042185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 08/06/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The impact of gastrointestinal endoscopy on COVID-19 infection remains poorly investigated. We herein performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 in patients undergoing gastrointestinal endoscopy. METHOD Ovid Medline, Ovid EMBASE, Ovid the Cochrane Library, and other electronic databases were searched until 30 November 2020 to identify publications with confirmed COVID-19 infection in patients undergoing gastrointestinal endoscopy. The primary outcomes were SARS-CoV-2 transmission, personal protective equipment use, rates of case fatality, complications, and procedural success. RESULTS A total of 18 articles involving 329 patients were included in this systematic review and meta-analysis. The overall basic reproduction rate is 0.37, while the subgroup results from Asia, Europe, and North America are 0.13, 0.44, and 0.33, respectively. The differences in personal protective equipment use between the positive transmission and non-transmission group are mainly in isolation gowns, N95 or equivalent masks, and goggles or face-shields. The rate of case fatality, complication, and procedural success are 0.17 (95% confidence interval = 0.02-0.38), 0.00 (95% confidence interval = 0.00-0.02), and 0.89 (95% confidence interval = 0.50-1.00), respectively. The fatality rate in Europe was the highest (0.23, 95% confidence interval = 0.04-0.50), which is significantly different from other continents (p = 0.034). CONCLUSION The risk of SARS-CoV-2 transmission within gastrointestinal endoscopy units is considerably low if proper use of personal protective equipment is applied. Similarly, a low fatality and complication rate, as well as a high procedural success rate, indicated that a full recovery of endoscopic units should be considered.
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Affiliation(s)
- Xiangzhou Tan
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China,Department of General, Visceral and Transplantation Surgery, Interdisciplinary Endoscopy Unit, University Hospital Tübingen, Tübingen, Germany
| | - Jianping Guo
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Zihua Chen
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Alfred Königsrainer
- Department of General, Visceral and Transplantation Surgery, Interdisciplinary Endoscopy Unit, University Hospital Tübingen, Tübingen, Germany
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17
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Oikonomou KG, Papamichalis P, Zafeiridis T, Xanthoudaki M, Papapostolou E, Valsamaki A, Bouliaris K, Papamichalis M, Karvouniaris M, Vlachostergios PJ, Skoura AL, Komnos A. Gastroenterology and liver disease during COVID-19 and in anticipation of post-COVID-19 era: Current practice and future directions. World J Clin Cases 2021; 9:4918-4938. [PMID: 34307544 PMCID: PMC8283616 DOI: 10.12998/wjcc.v9.i19.4918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/10/2021] [Accepted: 05/25/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a major threat to global public health. The virus causes the clinical syndrome known as coronavirus disease 2019 (COVID-19), in which multiple organs can get affected. Apart from manifestations of the respiratory system, which predominate, its clinical presentation is frequently accompanied by symptoms of the gastro-intestinal (GI) tract and liver abnormalities. The correlation of symptoms and abnormalities with disease severity is discussed, leading to ambiguous results from international literature. Moreover, the disease infects patients with co-existing liver and GI disorders affecting both their health status and the availability of healthcare services provided to them. The risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and GI diseases. For the safety of both doctors and patients, telemedicine and distant evaluation have become everyday practice, whereas several routines and emergency visits at outpatient and emergency departments have been postponed or delayed. Vaccination against SARS-CoV-2 is underway, providing hope to humanity and the expectation that the post-COVID-19 era is near. This review aims to update knowledge about the manifestations of COVID-19 related to liver and GI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.
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Affiliation(s)
- Katerina G Oikonomou
- Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
| | | | | | - Maria Xanthoudaki
- Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
| | | | - Asimina Valsamaki
- Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
| | | | - Michail Papamichalis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
| | - Marios Karvouniaris
- Intensive Care Unit, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
| | - Panagiotis J Vlachostergios
- Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, United States
| | - Apostolia-Lemonia Skoura
- Intensive Care Unit, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
- Transfusion Medicine Department, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
| | - Apostolos Komnos
- Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
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18
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Zaubitzer L, Ludwig S, Jungbauer F, Walter B, Lange B, Rotter N, Schell A. [Validity of SARS-CoV-2 swabs taken preoperatively in children]. Laryngorhinootologie 2021; 101:138-146. [PMID: 34010975 DOI: 10.1055/a-1494-3341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Due to the limited compliance, the technically correct collection of a pooled nasopharyngeal swab is significantly more difficult in children. Especially during operations in the area of the upper respiratory tract, there is a significantly increased risk of infection with COVID-19 for everyone present in the operating room. The aim of the study is to analyze the validity of SARS-CoV-2 swabs taken preoperatively under suboptimal conditions. MATERIAL AND METHODS Retrospective comparison of the PCR results of SARS-CoV-2 swaps taken preoperatively and intraoperatively from 62 children in the period from April to November 2020. Median age was 4.49 years. The PCR diagnosis was carried out one or two days preoperatively (in the case of emergency interventions on the same day) and again intraoperatively using a pooled nasopharyngeal swab. RESULTS All 62 preoperatively taken swabs were negative. Deviating from the preoperative test result, one intraoperatively obtained swab was positive. CONCLUSIONS Due to limited compliance, a correct preoperative swab technique (preanalytics) cannot always be assumed for children. Sufficient protective measures for everyone present in the operating room are therefore imperative. Intraoperative test should be considered if the the preoperative test was performed under difficult conditions.
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Affiliation(s)
| | | | | | | | - Bettina Lange
- Stabsstelle Hygiene, Universitätsklinikum Mannheim, Germany
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19
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Bowyer B, Thukral C, Patel S, Dovalovsky K, Bowyer SG, Ford J, Fox T, Ringler E. Outcomes of symptom screening and universal COVID-19 reverse transcriptase polymerase chain reaction testing before endoscopy in a community-based ambulatory surgery center. Gastrointest Endosc 2021; 93:1060-1064.e1. [PMID: 33039400 PMCID: PMC7543774 DOI: 10.1016/j.gie.2020.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/01/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Elective endoscopy resumed in our outpatient ambulatory center after instituting the preprocedure policy of a confirmed negative coronavirus disease 2019 (COVID-19) reverse transcriptase polymerase chain reaction (RT-PCR) status performed 72 hours before a scheduled procedure as mandated by the state of Illinois. In addition, all patients were required to contemporaneously complete the American Society for Gastrointestinal Endoscopy (ASGE) COVID-19 risk screening questionnaire published April 28, 2020 as outlined in the ASGE guidance document for reopening GI endoscopy during the COVID-19 pandemic. The aim of our study is to report the outcomes of 1000 patients who successfully completed the clinical aspects of the ASGE COVID-19 risk screening questionnaire and whose RT-PCR tests were valid for interpretation. METHODS Data were retrospectively collected from patient medical records for demographics, symptom responses to the preprocedure ASGE COVID-19 risk screening questionnaire, and RT-PCR test results of patients scheduled to undergo an elective outpatient endoscopy at Rockford Gastroenterology Associates from May 22 through June 28, 2020. Descriptive statistics and standard calculation methods to determine both positive and negative predictive values were used for data analysis. RESULTS Eight of 1000 patients included in the study tested positive for COVID-19. Three of 8 patients reported 1 or more symptoms on the ASGE COVID-19 risk screening questionnaire. One hundred nineteen additional patients reported symptoms on the ASGE COVID-19 risk screening questionnaire but tested negative for COVID-19. The positive and negative predictive values of the ASGE COVID-19 risk screening questionnaire were 2.46% and 99.43%, respectively. CONCLUSIONS The low incidence of COVID-19 infection in a community-based ambulatory surgery center is supported by a positive RT-PCR test rate of .80%. Absence of symptoms on the ASGE COVID-19 risk screening questionnaire was highly predictive of a negative RT-PCR test (99.43% negative predictive value), whereas the positive predictive value was low (2.46%) in symptomatic patients. A positive RT-PCR test was invaluable in preventing 5 asymptomatic patients from undergoing endoscopy. Similarly, 119 symptomatic patients underwent endoscopic evaluation who would have otherwise been excluded without RT-PCR testing. Symptom-based screening alone should not be the primary preprocedural assessment tool in selecting patients for undergoing endoscopy during the COVID-19 pandemic.
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Affiliation(s)
- Brad Bowyer
- Rockford Gastroenterology Associates, Rockford, Illinois, USA; University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
| | - Chandrashekhar Thukral
- Rockford Gastroenterology Associates, Rockford, Illinois, USA; University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
| | - Sunil Patel
- Rockford Gastroenterology Associates, Rockford, Illinois, USA; University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
| | - Katrina Dovalovsky
- University of Illinois College of Medicine Rockford, Rockford, Illinois, USA
| | | | - Joanne Ford
- Rockford Gastroenterology Associates, Rockford, Illinois, USA
| | - Taci Fox
- Rockford Gastroenterology Associates, Rockford, Illinois, USA
| | - Euella Ringler
- Rockford Gastroenterology Associates, Rockford, Illinois, USA
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20
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Hayee B, East J, Rees CJ, Penman I. Multicentre prospective study of COVID-19 transmission following outpatient GI endoscopy in the UK. Gut 2021; 70:825-828. [PMID: 32928914 PMCID: PMC7490915 DOI: 10.1136/gutjnl-2020-322730] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Bu'Hussain Hayee
- King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital NHS Foundation Trust, London, UK
| | - James East
- Translational Gastroenterology Unit, John Radcliffe Hospital Department of Gastroenterology, Oxford, Oxfordshire, UK
- Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Colin J Rees
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Ian Penman
- Royal Infirmary of Edinburgh, Edinburgh, UK
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21
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Bu J, Deng Z, Liu H, Li J, Wang D, Yang Y, Zhong S. Current methods and prospects of coronavirus detection. Talanta 2021; 225:121977. [PMID: 33592725 PMCID: PMC7833523 DOI: 10.1016/j.talanta.2020.121977] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/29/2020] [Accepted: 12/03/2020] [Indexed: 12/21/2022]
Abstract
SARS-COV-2 is a novel coronavirus discovered in Wuhan in December 30, 2019, and is a family of SARS-COV (severe acute respiratory syndrome coronavirus), that is, coronavirus family. After infection with SARS-COV-2, patients often experience fever, cough, gas prostration, dyspnea and other symptoms, which can lead to severe acute respiratory syndrome (SARS), kidney failure and even death. The SARS-COV-2 virus is particularly infectious and has led to a global infection crisis, with an explosion in the number of infections. Therefore, rapid and accurate detection of the virus plays a vital role. At present, many detection methods are limited in their wide application due to their defects such as high preparation cost, poor stability and complex operation process. Moreover, some methods need to be operated by professional medical staff, which can easily lead to infection. In order to overcome these problems, a Surface molecular imprinting technology (SM-MIT) is proposed for the first time to detect SARS-COV-2 virus. For this SM-MIT method, this review provides detailed detection principles and steps. In addition, this method not only has the advantages of low cost, high stability and good specificity, but also can detect whether it is infected at designated points. Therefore, we think SM-MIT may have great potential in the detection of SARS-COV-2 virus.
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Affiliation(s)
- Jiaqi Bu
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China
| | - Zhiwei Deng
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China
| | - Hui Liu
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China
| | - Jiacheng Li
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China
| | - De Wang
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China
| | - Yanjing Yang
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China.
| | - Shian Zhong
- College of Chemistry and Chemical Engineering, Central South University, Changsha, 410083, PR China.
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22
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Ebigbo A, Römmele C, Bartenschlager C, Temizel S, Kling E, Brunner J, Messmann H. Cost-effectiveness analysis of SARS-CoV-2 infection prevention strategies including pre-endoscopic virus testing and use of high risk personal protective equipment. Endoscopy 2021; 53:156-161. [PMID: 33080647 PMCID: PMC7869042 DOI: 10.1055/a-1294-0427] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Infection prevention strategies to protect healthcare workers in endoscopy units during the post-peak phase of the COVID-19 pandemic are currently under intense discussion. In this paper, the cost-effectiveness of routine pre-endoscopy testing and high risk personal protective equipment (PPE) is addressed. METHOD A model based on theoretical assumptions of 10 000 asymptomatic patients presenting to a high volume center was created. Incremental cost-effectiveness ratios (ICERs) and absolute costs per endoscopy were calculated using a Monte Carlo simulation. RESULTS ICER values for universal testing decreased with increasing prevalence rates. For higher prevalence rates (≥ 1 %), ICER values were lowest for routine pre-endoscopy testing coupled with use of high risk PPE, while cost per endoscopy was lowest for routine use of high risk PPE without universal testing. CONCLUSION In general, routine pre-endoscopy testing combined with high risk PPE becomes more cost-effective with rising prevalence rates of COVID-19.
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Affiliation(s)
- Alanna Ebigbo
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Christoph Römmele
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Christina Bartenschlager
- Chair of Health Care Operations/Health Information Management (UNIKA-T), Faculty of Business and Economics, University of Augsburg, Augsburg, Germany
| | - Selin Temizel
- Department of Hygiene and Environmental Medicine, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Elisabeth Kling
- Department of Laboratory Medicine and Microbiology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Jens Brunner
- Chair of Health Care Operations/Health Information Management (UNIKA-T), Faculty of Business and Economics, University of Augsburg, Augsburg, Germany
| | - Helmut Messmann
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
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23
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Khorrami Minaei S, Garrido Durán C, García Hernández M, García Amengual I, Mena Ribas A. POOR AGREEMENT BETWEEN CLINICAL SCREENING AND UNIVERSAL PRE-PROCEDURE SARS-CoV-2 PCR TESTING PRIOR TO ENDOSCOPY. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:649-655. [DOI: 10.17235/reed.2021.7612/2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Characteristics and Outcomes of Patients Undergoing Endoscopy During the COVID-19 Pandemic: A Multicenter Study from New York City. Dig Dis Sci 2021; 66:2545-2554. [PMID: 32930898 PMCID: PMC7490780 DOI: 10.1007/s10620-020-06593-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the practice of endoscopy, but characteristics of COVID patients undergoing endoscopy have not been adequately described. AIMS To compare findings, clinical outcomes, and patient characteristics of endoscopies performed during the pandemic in patients with and without COVID-19. METHODS This was a retrospective multicenter study of adult endoscopies at six academic hospitals in New York between March 16 and April 30, 2020. Patient and procedure characteristics including age, sex, indication, findings, interventions, and outcomes were compared in patients testing positive, negative, or untested for COVID-19. RESULTS Six hundred and five endoscopies were performed on 545 patients during the study period. There were 84 (13.9%), 255 (42.2%), and 266 (44.0%) procedures on COVID-positive, negative, and untested patients, respectively. COVID patients were more likely to undergo endoscopy for gastrointestinal bleeding or gastrostomy tube placement, and COVID patients with gastrointestinal bleeding more often required hemostatic interventions on multivariable logistic regression. COVID patients had increased length of stay, intensive care unit admission, and intubation rate. Twenty-seven of 521 patients (5.2%) with no or negative COVID testing prior to endoscopy later tested positive, a median of 13.5 days post-procedure. CONCLUSIONS Endoscopies in COVID patients were more likely to require interventions, due either to more severe illness or a higher threshold to perform endoscopy. A significant number of patients endoscoped without testing were subsequently found to be COVID-positive. Gastroenterologists in areas affected by the pandemic must adapt to changing patterns of endoscopy practice and ensure pre-endoscopy COVID testing.
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25
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Safety in Endoscopy for Patients and Healthcare Workers During the COVID-19 Pandemic. TECHNIQUES AND INNOVATIONS IN GASTROINTESTINAL ENDOSCOPY 2021; 23:170-178. [PMID: 33103130 PMCID: PMC7568769 DOI: 10.1016/j.tige.2020.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still wreaking havoc in many parts of the world and poses a great burden to healthcare systems worldwide. Mitigation and suppression strategies have been implemented globally but the disease has proven to be difficult to contain. Initially many elective gastrointestinal endoscopies were cancelled to reduce the risk of infection and conserve personal protective equipment, but many endoscopy units are now faced with the dilemma of resuming endoscopy service during the pandemic as indefinitely postponing diagnostic procedures may lead to a delay in the diagnosis and treatment of malignancies. Further concerns are surfacing as COVID-19 is now known to affect the gastrointestinal tract and may potentially be spread via the fecal-oral route. Until more effective drugs and vaccines are available, it is unlikely that the pandemic will wind down in the near future. Maintaining a balance between protecting healthcare workers and patients from being infected on the one hand and providing timely and effective clinical care on the other will become increasingly important as the pandemic persists. In this narrative review, the risk of COVID-19 infection for healthcare workers and patients undergoing endoscopy, and recommendations on maintaining safe, high-quality endoscopy practice will be discussed.
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26
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Jagtap N, Singh AP, Inavolu P, Tandan M, Lakhtakia S, Reddy DN. Clinical Impact of Universal Screening for COVID-19 before Therapeutic Endoscopy. JOURNAL OF DIGESTIVE ENDOSCOPY 2020. [DOI: 10.1055/s-0040-1722378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Abstract
Introduction The Coronavirus pandemic (COVID-19) has led to drastic change in gastrointestinal (GI) endoscopy practice. Endoscopy is an aerosol-generating procedure. COVID-19 testing prior to endoscopy can reduce transmission by delaying non-emergency endoscopies in positive patients. There is scarcity of literature to support such protocols. We aimed to study the clinical impact of universal testing for COVID-19 before therapeutic endoscopy.
Methods This is retrospective analysis of prospectively maintained data. All patients requiring therapeutic endoscopy were enrolled between June 15 to July 15, 2020. Clinical profile, indication, endoscopic intervention, and outcome of patients tested positive for COVID-19 real-time polymerase chain reaction (RT PCR) or CT chest suggestive of CO-RADS 3 or more were included for analysis.
Results Out of 772 patients scheduled for endoscopic interventions, 26 (3.34%) patients had COVID-19 infection with mean age (range) of 48.19 (3–75) years. Eight (30.8%) were females. Of them, seven (26.9%) patients underwent emergency endoscopy, and another seven (26.9%) patients underwent endoscopy after minimum of 2 weeks waiting period. Two deaths were seen in patients who underwent emergency interventions which were unrelated to endoscopy. One patient, who was planned for endoscopic ultrasound (EUS) for choledocholithiasis, developed acute biliary pancreatitis in the waiting period.
Conclusion We suggest use of universal testing for COVID-19 by RT-PCR before endoscopic intervention. Endoscopy can be postponed for 2 weeks with marginal risk of adverse events during the waiting period in nonemergency indications. However, this approach needs to be tailored as per local needs, resources availability, and indication of endoscopy.
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Affiliation(s)
- Nitin Jagtap
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | | | - Pradev Inavolu
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Manu Tandan
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - Sundeep Lakhtakia
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
| | - D Nageshwar Reddy
- Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India
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Abbas S, Rafique A, Abbas B, Iqbal R. Real-Time Polymerase chain reaction trends in COVID-19 patients. Pak J Med Sci 2020; 37:180-184. [PMID: 33437273 PMCID: PMC7794159 DOI: 10.12669/pjms.37.1.3000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To assess trends of real-time Polymerase Chain Reaction test in Coronavirus infected Patients. Methodology This cross-sectional analytical study was conducted at Tertiary Care Institute, Rawalpindi from March 2020 to June 2020. All patients confirmed COVID positive by real-time Polymerase Chain Reaction (PCR) with recent travel history, close contact with known diagnosed patients and had symptoms of fever or upper respiratory tract with body aches. Nasopharyngeal swabs were taken and results generated within 48 hours. Positive PCR was admission criteria follow up was carried out at 7th and 8th day, with negative PCR were discharged. However, those who had persistent positive PCR on the 8th day were tested again on 11th and 12th day. Those with persistent positive results beyond 12th day were shifted to specialized quarantine centres. Results A total of three hundred and ninety-two patients with mild to moderate illness, PCR positive for COVID 19 were included study with age range 9 - 45 and mean 33.22±7.98 years. A total of 8 (2%) patients were females and 384(98%) males. The duration of the negative test result was Mean ± Std. Deviation 9.05±2.00 with 7 - 8 days 152(38.8%)in and 11 - 12 days in 160(40.8%). PCR results on Day 7 and 8 were negative in 144(36.7%) patients whereas positive in 248(63.3%). PCR results on Day 11 and 12 were negative in 312(79.6%) patients whereas positive in 80 (20.4%). Conclusion To conclude Real-Time Polymerase Chain Reaction (rT-PCR) inclines to give false negative results additionally can stay positive in asymptomatic patients for moderately longer-term. Hence decision to discharge ought to be intricately adjusted between RT-PCR, clinical judgement, radiological examinations, and biochemical assays.
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Affiliation(s)
- Sana Abbas
- Dr. Sana Abbas, MCPS. National University of Medical Sciences Rawalpindi, Pakistan
| | - Aisha Rafique
- Dr. Aisha Rafique, MBBS. National University of Medical Sciences Rawalpindi, Pakistan
| | - Beenish Abbas
- Dr. Beenish Abbas, FCPS. Foundation University, Rawalpindi, Pakistan
| | - Rashid Iqbal
- Dr. Rashid Iqbal, FCPS Anaesthesia, FCPS Pain Medicine. National University of Medical Sciences Rawalpindi, Pakistan
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Perisetti A, Goyal H, Sharma N. Gastrointestinal Endoscopy in the Era of COVID-19. Front Med (Lausanne) 2020; 7:587602. [PMID: 33330546 PMCID: PMC7732601 DOI: 10.3389/fmed.2020.587602] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 10/09/2020] [Indexed: 01/25/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which led to a worldwide pandemic that started in early 2020. Healthcare systems across the world encountered an unprecedented surge of COVID-19 patients resulting in more than half a million deaths globally. COVID-19 has affected multiple sub-specialties and procedure-related fields, including gastroenterology. Gastrointestinal (GI) endoscopy centers are specialized units where thousands of endoscopies are performed annually. A significant proportion of these procedures are affected due to the national and regional lockdowns across the globe. To adapt to this rapidly evolving situation, endoscopy centers have undergone significant changes and have taken unprecedented precautions to avoid the transmission of the virus. However, endoscopy centers are going through financial strain due to a reduction in the number of procedures from lockdowns and fear of virus transmission. Theoretically, endoscopies could add to the disease transmission as SARS-CoV-2 has shown to be present in the GI secretions. Multiple precautions such as mandatory use of face masks, safe distancing, use of barriers between the endoscopists and patients, negative pressure rooms, extended use of personal protective equipment, and volume reduction have been taken to decrease the risk of disease transmission by these centers. Moreover, pre-endoscopy COVID-19 testing has now become the norm. In this review, we highlight the significant changes assumed by the endoscopy center. Furthermore, we discuss cost-related concerns of pre-endoscopy COVID-19 testing, the downtime and delays related to the procedures, and effects of rescheduling. As the pandemic progresses through multiple phases, endoscopy centers should use a dynamic approach to adapt and strive to provide the best patient care.
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Affiliation(s)
- Abhilash Perisetti
- Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Hemant Goyal
- The Wright Center for Graduate Medical Education, Scranton, PA, United States.,Mercer University School of Medicine, Macon, GA, United States
| | - Neil Sharma
- Division of Interventional Oncology & Surgical Endoscopy (IOSE), Parkview Cancer Institute, Fort Wayne, IN, United States.,Indiana University School of Medicine, Fort Wayne, IN, United States
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29
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Ralhan S, Arya RC, Gupta R, Wander GS, Gupta RK, Gupta VK, Bagga S, Mohan B. Cardiothoracic surgery during COVID-19: Our experience with different strategies. Ann Card Anaesth 2020; 23:485-492. [PMID: 33109808 PMCID: PMC7879916 DOI: 10.4103/aca.aca_166_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: An acute respiratory disease (COVID-19), caused by a novel coronavirus (SARS-CoV-2,), has been declared a pandemic by WHO. A surgery on COVID-19 patients not only involves a risk of spread of the disease but also there is a serious concern for the patient's surgical outcomes and resources requirement. Aim: The retrospective study is aimed to provide a protocol for pre-operative testing of SARS CoV-2 using RT-PCR in the patient undergoing cardio-thoracic surgeries. Material and Methods: To analyze the impact of pre-operative testing of SARS- CoV-2 using RT-PCR in the patient undergoing elective cardio-thoracic surgeries. The patient who underwent surgical interventions during the COVID-19 lockdown period was divided into two phases. Phase I (without COVID-19 RT-PCR testing) and Phase II (with pre-operative COVID-19 RT-PCR testing). The retrospective comparison between the two study groups was done using Student t-test, Mann–Whitney U, and Chi square (χ2) test depending upon the clinical variable to be analyzed. Results: During the early phase (phase I), 26 patients underwent cardio-thoracic surgery without COVID-19 RT-PCR test. Whereas, during phase II, all patients were tested for COVID-19 using RT-PCR, preoperatively and a total of 64 surgeries were performed during this phase. One patient planned for CABG was positive on RT-PCR for COVID-19 and was sent to the quarantine ward. The difference in the pre-operative hospital stay between two groups was found to be statistically significant and a significant decrease in the number of PPE kits used, during the phase I. Conclusion: All asymptomatic patients should be tested for COVID-19 using RT-PCR prior to cardio-thoracic surgeries not only to contain the disease but to avoid potential implications of COVID-19 on the perioperative course, without added financial implications.
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Affiliation(s)
- Sarju Ralhan
- Department of CTVS, Chief Cardiac Surgeon, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Rajesh C Arya
- Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Rama Gupta
- Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Gurpreet S Wander
- Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Rajiv K Gupta
- Department of CTVS, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Vivek K Gupta
- Department of Cardiac Anaesthesia and Intensive Care, Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Suhani Bagga
- Dayanand Medical College & Hospital, Ludhiana, Punjab, India
| | - Bishav Mohan
- Department of Cardiology, Hero DMC Heart Institute, Ludhiana, Punjab, India
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Sultan S, Siddique SM, Altayar O, Caliendo AM, Davitkov P, Feuerstein JD, Francis D, Inadomi JM, Lim JK, Falck-Ytter Y, Mustafa RA. AGA Institute Rapid Review and Recommendations on the Role of Pre-Procedure SARS-CoV-2 Testing and Endoscopy. Gastroenterology 2020; 159:1935-1948.e5. [PMID: 32735862 PMCID: PMC7386603 DOI: 10.1053/j.gastro.2020.07.043] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Shahnaz Sultan
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis Veterans Affairs Healthcare System, Minneapolis, Minnesota
| | - Shazia M Siddique
- Division of Gastroenterology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Osama Altayar
- Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri
| | - Angela M Caliendo
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Perica Davitkov
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Joseph D Feuerstein
- Division of Gastroenterology and Center for Inflammatory Bowel Diseases, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Dawn Francis
- Mayo Clinic College of Medicine, Division of Gastroenterology and Hepatology, Jacksonville, Florida
| | - John M Inadomi
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Joseph K Lim
- Yale Liver Center and Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Northeast Ohio Veterans Affairs Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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Fiori G, Trovato C, Staiano T, Magarotto A, Stigliano V, Masci E, Ciuffi M, Rossi GB, Fantin A, Realdon S, Ugenti I, Cannizzaro R. Reorganization of the endoscopic activity of Cancer Institutes during phase II of the Covid-19 emergency. Dig Liver Dis 2020; 52:1346-1350. [PMID: 32601037 PMCID: PMC7294252 DOI: 10.1016/j.dld.2020.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 12/11/2022]
Abstract
After the lockdown during the emergency phase of the Covid-19 pandemic, we have to deal with phase 2, a period of uncertain duration, with a controlled and progressive return to normalization, in which we need to reconcile our work and our movements with the presence of the virus on our territory. Digestive endoscopic activity is a high-risk transmission procedure for Covid-19. The measures put in place to protect healthcare personnel and patients are stressful and "time-consuming" and lead to a reduction in the number of endoscopic procedures that can be performed. In this scenario, the Oncological Institutes are forced to make a rigorous selection of patients to undergo endoscopic examinations and treatments, according to lists of exceptional priorities, in order to guarantee cancer patients and subjects at high risk of developing digestive tumors, a preferential diagnostic and therapeutic process, protected from contagion risks. For this purpose, cuts and postponing times of endoscopic performances are here proposed, which go beyond the guidelines of scientific societies and have little evidences in the literature. These changes should be applied limited to this exceptional period and in proportion to the capacity of each operating unit in order to meet the demands of the patients.
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Affiliation(s)
- Giancarla Fiori
- Division of Endoscopy, European Institute of Oncology, Istituto di Ricovero a Cura e Carattere Scientifico (IRCCS), Milan, Italy
| | - Cristina Trovato
- Division of Endoscopy, European Institute of Oncology, Istituto di Ricovero a Cura e Carattere Scientifico (IRCCS), Milan, Italy
| | - Teresa Staiano
- Diagnostic and Interventional Endoscopy, Candiolo Cancer Institute, FPO - IRCCS - Str. Prov.le 142, km. 3,95 - Candiolo (TO) 10060, Italy
| | - Andrea Magarotto
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Vittoria Stigliano
- Division of Gastroenterology and Digestive Endoscopy, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Enzo Masci
- Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Mario Ciuffi
- Endoscopy Unit, IRCCS Centro di Riferimento Oncologico di Basilicata (CROB), 85028 Rionero in Vulture (PZ), Italy
| | - Giovanni Battista Rossi
- Gastroenterology and Digestive Endoscopy Unit, Istituto Nazionale per lo Studio e la Cura dei Tumori, IRCCS, Fondazione Giovanni Pascale I-80131 Naples, Italy
| | - Alberto Fantin
- U.O. Gastroenterologia IRCCS- Istituto Oncologico Veneto Castelfranco Veneto (TV), Italy
| | - Stefano Realdon
- Digestive Endoscopy Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Ippazio Ugenti
- Division of Digestive Endoscopy, Istituto Tumori Giovanni Paolo II, IRCCS, Bari, Italy,D.E.T.O. University of Bari, Italy
| | - Renato Cannizzaro
- Gastroenterologia Oncologica Sperimentale, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Via Franco Gallini, 2, 33081 Aviano, Italy,Corresponding author
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Perisetti A, Goyal H, Gajendran M, Boregowda U, Mann R, Sharma N. Prevalence, Mechanisms, and Implications of Gastrointestinal Symptoms in COVID-19. Front Med (Lausanne) 2020; 7:588711. [PMID: 33195352 PMCID: PMC7662553 DOI: 10.3389/fmed.2020.588711] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. The infection started as an outbreak of pneumonia-like symptoms in Wuhan, China. Within a few weeks, it spread across the entire globe resulting in millions of cases and thousands of deaths. While respiratory symptoms and complications are well-defined and can be severe, non-respiratory symptoms of COVID-19 are increasingly being recognized. Gastrointestinal manifestations such as nausea, vomiting, diarrhea, and abdominal pain have been added to the list of common COVID-19 symptoms. Their prevalence has been increasing, probably due to increased recognition and experience with the pandemic. Furthermore, diarrhea and stool testing may change prevalence and transmission rates due to suspicion for fecal-oral transmission of the COVID-19. Due to this risk, various countries have started testing wastewater and sewage systems to examine its role in the spread of SARS-CoV-2 among communities. In this review article, we describe the common gastrointestinal manifestations in COVID-19, their prevalence based upon the current literature, and highlight the importance of early recognition and prompt attention. We also note the role of fecal-oral transmission. Furthermore, the mechanisms of these symptoms, the role of medications, and potential contributing factors are also elaborated.
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Affiliation(s)
- Abhilash Perisetti
- Department of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Hemant Goyal
- The Wright Center for Graduate Medical Education, Scranton, PA, United States
- Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, United States
| | - Mahesh Gajendran
- Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, United States
| | - Umesha Boregowda
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, United States
| | - Rupinder Mann
- Saint Agnes Medical Center, Academic Hospitalists, Fresno, CA, United States
| | - Neil Sharma
- Division of Interventional Oncology and Surgical Endoscopy (IOSE), Parkview Cancer Institute, Fort Wayne, IN, United States
- Division of Interventional Oncology and Surgical Endoscopy, Indiana University School of Medicine, Fort Wayne, IN, United States
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Vanella G, Capurso G, Boškoski I, Bossi E, Signorelli C, Ciceri F, Arcidiacono PG, Costamagna G. How to get away with COVID-19: endoscopy during post-peak pandemic. A perspective review. Therap Adv Gastroenterol 2020; 13:1756284820965070. [PMID: 33093872 PMCID: PMC7548539 DOI: 10.1177/1756284820965070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023] Open
Abstract
The SARS-CoV-2 pandemic has changed the way we work, and health care services have to adapt. The use of personal protective equipment (PPE) and the delay of non-urgent procedures were the immediate measures adopted by Gastrointestinal (GI) Endoscopy Units at the time of crisis. As the peak has now passed in most countries, GI facilities are facing the next challenge of this pandemic: service providers must adapt their routine work to a 'new normal'. Routine casework must resume, and waiting lists must be addressed: all in the awareness of the ongoing potential risks of COVID-19, and the threat of a second wave. In this review, we discuss strategies to manage the workload by improving procedure appropriateness and prioritization, whilst maintaining a 'COVID-free' environment. This includes monitoring of an adequate stock of PPE and the implications for the staff's workload, and the GI trainees' need of training.
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Affiliation(s)
- Giuseppe Vanella
- Pancreatobiliary Endoscopy and Endosonography
Division, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele
University, Milan, Italy
| | - Gabriele Capurso
- Pancreatobiliary Endoscopy and Endosonography
Division, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele
University, Milan, Italy
| | - Ivo Boškoski
- Digestive Endoscopy Unit, Fondazione Policlinico
Universitario Agostino Gemelli IRCCS, Rome, Italy,Centre for Endoscopic Research Therapeutics and
Training (CERTT), Università Cattolica del Sacro Cuore di Roma, Italy
| | - Eleonora Bossi
- School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
| | - Carlo Signorelli
- School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
| | - Fabio Ciceri
- Department of Haematology and Stem Cell
Transplantation, IRCCS San Raffaele Scientific Institute, Vita-Salute San
Raffaele University, Milan, Italy
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Moraveji S, Thaker AM, Muthusamy VR, Banerjee S. Protocols, Personal Protective Equipment Use, and Psychological/Financial Stressors in Endoscopy Units During the COVID-19 Pandemic: A Large Survey of Hospital-Based and Ambulatory Endoscopy Centers in the United States. Gastroenterology 2020; 159:1568-1570.e5. [PMID: 32464147 PMCID: PMC7255133 DOI: 10.1053/j.gastro.2020.05.061] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Sharareh Moraveji
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California
| | - Adarsh M. Thaker
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California–Los Angeles, Los Angeles, California
| | - V. Raman Muthusamy
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California–Los Angeles, Los Angeles, California
| | - Subhas Banerjee
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California.
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35
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Affiliation(s)
- Juan E Corral
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Michael B Wallace
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
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36
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Recommendations of the Spanish Association of Neurogastroenterology and Motility (ASENEM) to restart the activity of gastrointestinal motility laboratories after the state of alarm called due to the COVID-19 pandemic. GASTROENTEROLOGÍA Y HEPATOLOGÍA (ENGLISH EDITION) 2020. [PMCID: PMC7546965 DOI: 10.1016/j.gastre.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for the outbreak of the 2019 coronavirus disease (COVID-19), which is now considered as a pandemic. The prevention strategies adopted have included social distancing measures and the modification, reduction or interruption of a large proportion of routine healthcare activity. This has had a significant impact on the care provided in Gastrointestinal Motility Units. Having passed the peak, in terms of mortality and infections, a gradual reduction in transmission figures has been observed in Spain and other European countries. The risk of reactivation, however, remains high, so it is necessary to have a plan in place that allows healthcare centres to safely resume, for their patients and professionals, instrumental examinations linked to the management of motor pathology. Based on the available scientific evidence and the consensus of a panel of experts, the Spanish Association of Neurogastroenterology and Motility (ASENEM) has drawn up a series of practical recommendations, which have been adapted to the risks inherent in each activity. These include individual protection proposals, as well as organisational and structural measures, which are conceived to allow for the gradual resumption of examinations while minimising the possibility of contagion.
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Gralnek IM, Hassan C, Beilenhoff U, Antonelli G, Ebigbo A, Pellisé M, Arvanitakis M, Bhandari P, Bisschops R, Van Hooft JE, Kaminski MF, Triantafyllou K, Webster G, Voiosu AM, Pohl H, Dunkley I, Fehrke B, Gazic M, Gjergek T, Maasen S, Waagenes W, de Pater M, Ponchon T, Siersema PD, Messmann H, Dinis-Ribeiro M. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey. Endoscopy 2020; 52:891-898. [PMID: 32643767 PMCID: PMC7520543 DOI: 10.1055/a-1213-5761] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Ian M. Gralnek
- Ellen and Pinchas Mamber Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, and Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel
| | | | | | | | - Alanna Ebigbo
- III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Maria Pellisé
- Department of Gastroenterology, Hospital Clinic de Barcelona. Institut d’Investigacions Biomediques August Pi i Sunyer (IDIBAPS), and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Universitat de Barcelona, Barcelona, Spain
| | - Marianna Arvanitakis
- Department of Gastroenterology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Pradeep Bhandari
- Gastroenterology, Portsmouth Hospital NHS Trust, Portsmouth, United Kingdom
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, Catholic University of Leuven (KUL), TARGID, University Hospitals Leuven, Leuven, Belgium
| | - Jeanin E. Van Hooft
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michal F. Kaminski
- Department of Cancer Prevention and Department of Oncological Gastroenterology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, 2nd Department of Internal Medicine – Propaedeutic, Medical School, National and Kapodistrian University of Athens, Attikon University General Hospital, Athens, Greece
| | - George Webster
- Department of Gastroenterology, University College London Hospitals, London, United Kingdom
| | - Andrei M. Voiosu
- Department of Gastroenterology and Hepatology, Colentina Clinical Hospital, Bucharest, Romania
| | - Heiko Pohl
- Dartmouth Geisel School of Medicine, Hanover New Hampshire, VA Medical Center, Section of Gastroenterology, White River Junction, Vermont, USA
| | - Irene Dunkley
- North West Anglia NHS Foundation Trust, Hinchingbrooke, United Kingdom
| | | | | | | | | | | | | | - Thierry Ponchon
- Gastroenterology Division, Edouard Herriot Hospital, Lyon, France
| | - Peter D. Siersema
- Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Helmut Messmann
- III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Mario Dinis-Ribeiro
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Portugal
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Alcedo J, Serra J, Pérez de la Serna J, Mas P, Barba E, Suárez JF, Accarino A. Recommendations of the Spanish Association of Neurogastroenterology and Motility (ASENEM) to restart the activity of gastrintestinal motility laboratories after the state of alarm called due to the Covid-19 pandemic. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 43:485-496. [PMID: 32680731 PMCID: PMC7301085 DOI: 10.1016/j.gastrohep.2020.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 01/15/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for the outbreak of the 2019 coronavirus disease (COVID-19), which is now considered as a pandemic. The prevention strategies adopted have included social distancing measures and the modification, reduction or interruption of a large proportion of routine healthcare activity. This has had a significant impact on the care provided in Gastrointestinal Motility Units. Having passed the peak, in terms of mortality and infections, a gradual reduction in transmission figures has been observed in Spain and other European countries. The risk of reactivation, however, remains high, so it is necessary to have a plan in place that allows healthcare centres to safely resume, for their patients and professionals, instrumental examinations linked to the management of motor pathology. Based on the available scientific evidence and the consensus of a panel of experts, the Spanish Association of Neurogastroenterology and Motility (ASENEM) has drawn up a series of practical recommendations, which have been adapted to the risks inherent in each activity. These include individual protection proposals, as well as organisational and structural measures, which are conceived to allow for the gradual resumption of examinations while minimising the possibility of contagion.
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Affiliation(s)
- Javier Alcedo
- Sección de Trastornos Funcionales y Motores Digestivos, Servicio de Aparato Digestivo, Hospital Universitario Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.
| | - Jordi Serra
- Unidad de Trastornos Motores y Funcionales Digestivos, Servicio de Aparato Digestivo, Hospital Universitario Germans Trias i Pujol, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España
| | - Julio Pérez de la Serna
- Unidad de Motilidad, Servicio de Aparato Digestivo, Instituto de Investigación Sanitaria, Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, España
| | - Pilar Mas
- Unidad de Motilidad Digestiva, Servicio de Medicina Digestiva, Hospital Clínico Universitario, Valencia, España
| | - Elizabeth Barba
- Unidad de Pruebas Funcionales Digestivas, Servicio de Aparato Digestivo, Hospital General Vall d́Hebron, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España
| | - José Francisco Suárez
- Unidad de Exploraciones Funcionales Digestivas, Hospital Universitario Torrecárdenas, Almería, España
| | - Anna Accarino
- Unidad de Pruebas Funcionales Digestivas, Servicio de Aparato Digestivo, Hospital General Vall d́Hebron, Barcelona, España; Universidad Autónoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, España
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Badillo R, Guha S, Ramireddy S, DaVee RT, Thosani N. Economic model to restart endoscopy practice needs to consider impact on health disparity in minority groups. Gastrointest Endosc 2020; 92:986-987. [PMID: 32964851 PMCID: PMC7505068 DOI: 10.1016/j.gie.2020.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 05/10/2020] [Indexed: 02/08/2023]
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Corral JE, Wallace MB. Response. Gastrointest Endosc 2020; 92:791-792. [PMID: 32838914 PMCID: PMC7441880 DOI: 10.1016/j.gie.2020.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 02/08/2023]
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Sundaram S. COVID-19 testing before every endoscopy: Is India ready for prime time? Gastrointest Endosc 2020; 92:789-791. [PMID: 32416103 PMCID: PMC7235597 DOI: 10.1016/j.gie.2020.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Sridhar Sundaram
- Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India
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Cherry G, Rocke J, Chu M, Liu J, Lechner M, Lund VJ, Kumar BN. Loss of smell and taste: a new marker of COVID-19? Tracking reduced sense of smell during the coronavirus pandemic using search trends. Expert Rev Anti Infect Ther 2020; 18:1165-1170. [PMID: 32673122 PMCID: PMC7441792 DOI: 10.1080/14787210.2020.1792289] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objectives It has been demonstrated that reduction in smell and/or taste is the most predictive symptom in SARS-CoV-2/Covid-19 infection. We used Google Trends to analyze regional searches relating to loss of smell and taste across Italy, Spain, France, Brazil, and the United States of America and determined the association with reported Covid-19 cases. Methods In order to retrieve the data, we built a Python software program that provides access to Google Trends data via an application program interface. Daily COVID-19 case data for subregions of the five countries selected were retrieved from respective national health authorities. We sought to assess the association between raw search interest data and COVID-19 new daily cases per million for all regions individually. Results In total, we yielded 2188 sets of Google Trends data which included 548 time series of 4 anosmia and ageusia search concepts over the study period for 137 regions. These data indicated that differences in search interest for terms relating to anosmia and ageusia, between regions, is associated with geographical trends in new Covid-19 cases. Conclusions We feel that Google search trends relating to loss of smell can be utilized to identify potential Covid-19 outbreaks on a national and regional basis.
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Affiliation(s)
| | - John Rocke
- Wigan and Leigh Teaching Hospitals NHS Foundation Trust , Wrightington, UK
| | - Michael Chu
- Wigan and Leigh Teaching Hospitals NHS Foundation Trust , Wrightington, UK
| | - Jacklyn Liu
- UCL Cancer Institute, University College London , London, UK
| | - Matt Lechner
- UCL Cancer Institute, University College London , London, UK.,Barts Health NHS Trust, Royal London Hospital and Whipps Cross University Hospital , UK
| | - Valerie J Lund
- Royal National Throat Nose and Ear Hospital, UCLH Foundation Trust , UK
| | - B Nirmal Kumar
- Wigan and Leigh Teaching Hospitals NHS Foundation Trust , Wrightington, UK
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Ali MJ. COVID-19 pandemic and lacrimal practice: Multipronged resumption strategies and getting back on our feet. Indian J Ophthalmol 2020; 68:1292-1299. [PMID: 32587153 PMCID: PMC7574051 DOI: 10.4103/ijo.ijo_1753_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/24/2022] Open
Abstract
The aim of this review was to propose multi-pronged resumption strategies for lacrimal practice in an effort to plan a sustainable recommencement of elective surgeries after we emerge from the peak of COVID-19 pandemic. The strategies for lacrimal practice were classified into 7 subtypes, and each of the blueprints were reassessed based on existing information on resumption strategies of elective surgeries from other specialties in COVID-19 era. The specific needs of lacrimal practice were then added to construct algorithms summarizing the resumption strategies. The basic principle of 'primum non nocere' needs to be followed. The overall proposed plan advocates the transition to a more sustainable health care reality in a world where we would still co-exist with COVID-19. A comprehensive effort involving screening, laboratory testing, appropriate triage, effective personal protection and specific precautionary measures for lacrimal clinics and operating room are needed to be able to safely resume elective surgery when the pandemic peak declines. To predict the timing of the resumption of elective surgeries is quite complex and influenced by several geographic, political and economic factors. It is equally important to remember that COVID-19 crisis is a dynamic situation and constantly evolving, hence the strategies provided are subject to change. Strict adherence to standard COVID-19 guidelines combined with effective testing and personal protection strategies can ensure slow yet smooth and safe return to full lacrimal practice after the COVID-19 pandemic calms down. The local government directives, individual and institutional discretion are advised.
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Affiliation(s)
- Mohammad Javed Ali
- Govindram Seksaria Institute of Dacryology, L.V. Prasad Eye Institute, Hyderabad, Telangana, India
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Tack J, Vanuytsel T, Serra J, Accarino A, Stanghellini V, Barbara G. European Society for Neurogastroenterology and Motility recommendations for conducting gastrointestinal motility and function testing in the recovery phase of the COVID-19 pandemic. Neurogastroenterol Motil 2020; 32:e13930. [PMID: 32525249 PMCID: PMC7300574 DOI: 10.1111/nmo.13930] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND During the peak of the COronaVIrus Disease 2019 (COVID-19) pandemic, care for patients with gastrointestinal motility and functional disorders was largely suspended. In the recovery phases of the pandemic, non-urgent medical care is resumed, but there is a lack of guidance for restarting and safely conducting motility and function testing. Breath tests and insertion of manometry and pH-monitoring probes carry a risk of SARS-CoV-2 spread through droplet formation. METHODS A panel of experts from the European Society for Neurogastroenterology and Motility (ESNM) evaluated emerging national and single-center recommendations to provide the best current evidence and a pragmatic approach to ensure the safe conduct of motility and function testing for both healthcare professionals and patients. RESULTS At a general level, this involves evaluation of the urgency of the procedure, evaluation of the infectious risk associated with the patient, the investigation and the healthcare professional(s) involved, provision of the test planning and test units, education and training of staff, and use of personnel protection equipment. Additional guidance is provided for specific procedures such as esophageal manometry, pH monitoring, and breath tests. CONCLUSIONS AND INFERENCES The ESNM guidelines provide pragmatic and appropriate guidance for the safe conduct of motility and function testing in the COVID-19 pandemic and early recovery phase.
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Affiliation(s)
- Jan Tack
- Department of Chronic DiseasesTranslational Research Center for Gastrointestinal Disorders (TARGID), Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Rome FoundationFalls of NeuseChapel HillNCUSA
| | - Tim Vanuytsel
- Department of Chronic DiseasesTranslational Research Center for Gastrointestinal Disorders (TARGID), Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Jordi Serra
- Motility and Functional Gut Disorders UnitUniversity Hospital Germans Trias i PujolBadalonaSpain
- Centro de Investigación Biomédica en Red de enfermedades hepaticas y digestivas (CIBERehd)BarcelonaSpain
| | - Anna Accarino
- Centro de Investigación Biomédica en Red de enfermedades hepaticas y digestivas (CIBERehd)BarcelonaSpain
- Digestive System Research UnitUniversity Hospital Vall d’HebronBarcelonaSpain
| | - Vincenzo Stanghellini
- Department of Digestive Diseases and Internal MedicineUniversity of BolognaSt Orsola‐Malpighi HospitalBolognaItaly
| | - Giovanni Barbara
- Department of Digestive Diseases and Internal MedicineUniversity of BolognaSt Orsola‐Malpighi HospitalBolognaItaly
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Tack J, Schol J, Geeraerts A, Huang I, Mori H, Scarpellini E, Sinonquel P, Carbone F, Colomier E, Geysen H, Jandee S, Moonen A, Pannemans J, Timmermans L, Van den Houte K, Verbeure W, Wauters L, Bisschops R, Hoffman I, Roelandt P, Rommel N, Simren M, Suzuki H, Tornblom H, Verbeke K, Vanuytsel T. A survey on the impact of the COVID-19 pandemic on motility and functional investigations in Europe and considerations for recommencing activities in the early recovery phase. Neurogastroenterol Motil 2020; 32:e13926. [PMID: 32478910 PMCID: PMC7300498 DOI: 10.1111/nmo.13926] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The COVID-19 pandemic, declared by WHO on March 13, 2020, had a major global impact on the healthcare system and services. In the acute phase, the presence of the SARS-CoV-2 virus in the aerodigestive tract limited activities in the gastroenterology clinic and procedures to emergencies only. Motility and function testing was interrupted and as we enter the recovery phase, restarting these procedures requires a safety-focused approach with adequate infection prevention for patients and healthcare professionals. METHODS We summarized knowledge on the presence of the SARS-CoV-2 virus in the aerodigestive tract and the risk of spread with motility and functional testing. We surveyed 39 European centers documenting how the pandemic affected activities and which measures they are considering for restarting these measurements. We propose recommendations based on current knowledge as applied in our center. RESULTS Positioning of catheters for gastrointestinal motility tests carries a concern for aerosol-borne infection of healthcare workers. The risk is low with breath tests. The surveyed centers stopped almost all motility and function tests from the second half of March. The speed of restarting and the safety measures taken varied highly. CONCLUSIONS AND INFERENCES Based on these findings, we provided recommendations and practical relevant information for motility and function test procedures in the COVID-19 pandemic era, to guarantee a high-quality patient care with adequate infection prevention.
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Affiliation(s)
- Jan Tack
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium,Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium,Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Jolien Schol
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Annelies Geeraerts
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - I‐Hsuan Huang
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Hideki Mori
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Emidio Scarpellini
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Pieter Sinonquel
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Florencia Carbone
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Esther Colomier
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Hannelore Geysen
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Sawangpong Jandee
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - An Moonen
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Jasper Pannemans
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Lien Timmermans
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Karen Van den Houte
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Wout Verbeure
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Lucas Wauters
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Raf Bisschops
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Ilse Hoffman
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Philip Roelandt
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Nathalie Rommel
- Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
| | - Magnus Simren
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Hidekazu Suzuki
- Division of Gastroenterology and HepatologyDepartment of Internal MedicineSchool of MedicineTokai UniversityIseharaKanagawaJapan
| | - Hans Tornblom
- Department of Internal Medicine & Clinical NutritionInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Kristin Verbeke
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium
| | - Tim Vanuytsel
- Translational Research Center for Gastrointestinal Disorders (TARGID)Department of Chronic Diseases, Metabolism and Ageing (CHROMETA)KU LeuvenLeuvenBelgium,Division of Gastroenterology and HepatologyLeuven University HospitalsLeuvenBelgium
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COVID-19 testing before endoscopy safe, effective in the US. PHARMACOECONOMICS & OUTCOMES NEWS 2020; 853:14. [PMID: 32454585 PMCID: PMC7228866 DOI: 10.1007/s40274-020-6809-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Airway Management Considerations for Upper Gastrointestinal Endoscopic Procedures in COVID-19 Era. Dig Dis Sci 2020; 65:2739-2742. [PMID: 32712781 PMCID: PMC7382315 DOI: 10.1007/s10620-020-06478-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/04/2020] [Indexed: 12/09/2022]
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