- Upper gastrointestinal (GI) endoscopy is a high-risk procedure.
- All patients scheduled for endoscopy should be classified according to their risk of COVID-19 based on the presence of respiratory symptoms, risk contacts and recent travel.
- AGA recommends wearing N95 instead of the surgical mask for upper and lower endoscopy.
- AGA recommends wearing double gloves for all endoscopies.
- Endoscopies should be performed in a negative-pressure room for all patients stratified at high-risk or positive for COVID-19.
- All patients should be wearing a surgical mask unless oxygen is needed to maintain an adequate saturation level
- According to studies on lower GI bleeding, colonoscopy could be delayed up to 72 hours with no effect on the effectiveness of treatments (blood transfusion or surgery). However, for upper GI bleeding,gastroscopy should be performed within 24 hours.
This data comes from 2 studies. Recipi A et al. conducted an observational study that outlines the measures that should be implemented in the endoscopy department during COVID-19 outbreak. They focus on protection equipment and dressing code. Sultan S. et al. presented the recommendations from the American Gastroenterological Association (AGA) for GI procedures.
Sources:
- Repici A., Maselli R., Colombo M., et al. (March 12, 2020). Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointestinal endoscopy. https://doi.org/10.1016/j.gie.2020.03.019
- Sultan S, Lim J. , Altayar O., et al March 23, 2020) AGA Institute Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic, Gastroenterology. https://doi.org/10.1053/j.gastro.2020.03.072