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Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy.

ABSTRACT: Since December 2019, a novel coronavirus disease, COVID-19, has occurred in China and has spread around the world rapidly. As an acute respiratory infectious disease, COVID-19 has been included in type B infectious diseases and managed according to the standard of type A infectious disease in China. Given the high risk of COVID-19 infection during endoscopic procedures via an airborne route, the Chinese Society of Digestive Endoscopy issued a series of recommendations to guide the endoscopy works in China during the pandemic. To the best of our knowledge, no new infectious case of COVID-19 resulting from endoscopic procedures has been reported in China to date. Here, these recommendations are integrated to provide guidance about the prevention of COVID-19 for endoscopists. The recommendations include advice about postponing non-urgent endoscopies, excluding the possibility of COVID-19 in patients undergoing endoscopy, protection of medical staff from coronavirus infection, and cleaning of endoscopy centres.

SUBMITTER: Chai N

PROVIDER: S-EPMC7335943 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy.

Chai Ningli N Mei Zhechuan Z Zhang Wengang W Du Chen C Wang Xiangyao X Li Longsong L Ma Yan Y Zou Jiale J Tang Xiaowei X Wang Nanjun N Feng Jiancong J Linghu Enqiang E

United European gastroenterology journal 20200702 7

Since December 2019, a novel coronavirus disease, COVID-19, has occurred in China and has spread around the world rapidly. As an acute respiratory infectious disease, COVID-19 has been included in type B infectious diseases and managed according to the standard of type A infectious disease in China. Given the high risk of COVID-19 infection during endoscopic procedures via an airborne route, the Chinese Society of Digestive Endoscopy issued a series of recommendations to guide the endoscopy work ...[more]

PMID: 32615871

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Project description:PurposeTo collate best practice recommendations on the management of patients receiving in-center hemodialysis during the COVID-19 pandemic, based on published reports and current public health advice, while considering ethical principles and the unique circumstances of Canadian hemodialysis units across the country.Sources of informationThe workgroup members used Internet search engines to retrieve documents from provincial and local hemodialysis programs; provincial public health agencies; the Centers for Disease Control and Prevention; webinars and slides from other kidney agencies; and nonreviewed preprints. PubMed was used to search for peer-reviewed published articles. Informal input was sought from knowledge users during a webinar.MethodsChallenges in the care of hemodialysis patients during the COVID-19 pandemic were highlighted within the Canadian Senior Renal Leaders Forum discussion group. The Canadian Society of Nephrology (CSN) developed the COVID-19 rapid response team (RRT) to address these challenges. They identified a pan-Canadian team of clinicians and administrators with expertise in hemodialysis to form the workgroup. One lead was chosen who drafted the initial document. Members of the workgroup reviewed and discussed all recommendations in detail during 2 virtual meetings on April 7 and April 9. Disagreements were resolved by consensus. The document was reviewed by the CSN COVID-19 RRT, an ethicist, an infection control expert, a community nephrologist, and a patient partner. Content was presented during an interactive webinar on April 11, 2020 attended by 269 kidney health professionals, and the webinar and first draft of the document were posted online. Final revisions were made based on feedback received until April 13, 2020. CJKHD editors reviewed the parallel process peer review and edited the manuscript for clarity.Key findingsRecommendations were made under the following themes: (1) Identification of patients with COVID-19 in the dialysis unit, (2) hemodialysis of patients with confirmed COVID-19, (3) hemodialysis of patients not yet known to have COVID-19, (4) visitors; (5) testing for COVID-19 in the dialysis unit; (6) resuscitation, (6) routine hemodialysis care, (7) hemodialysis care under fixed dialysis resources.LimitationsBecause of limitations of time and resources, and the large number of questions, formal systematic review was not undertaken. The recommendations are based on expert opinion and subject to bias. The parallel review process that was created may not be as robust as the standard peer review process.ImplicationsWe hope that these recommendations provide guidance for dialysis unit directors, clinicians, and administrators on how to limit risk from infection and adverse outcomes, while providing necessary dialysis care in a setting of finite resources. We also identify a number of resource allocation priorities, which we hope will inform decisions at provincial funding agencies.

Project description:BackgroundThe quality of gastrointestinal (GI) endoscopy has been recently identified as a major priority being associated with many outcomes and patient's experience.ObjectiveTo assess adherence of endoscopists to the European Society of Gastrointestinal Endoscopy (ESGE) quality performance measures for upper and lower GI endoscopy in Italy.MethodsAll endoscopist members of the Italian Society of Digestive Endoscopy (SIED) were invited from October 2018 to December 2018 to participate to a self-administered questionnaire-based survey. The questionnaire included questions on demographics and professional characteristics, and the recent ESGE quality performance measures for upper and lower GI endoscopy.ResultsA total of 392 endoscopists participated in the study. Only a minority (18.2%) of participants recorded the duration of esophagogastroduodenoscopy (EGD) and 51% provided accurate photo documentation in the minimum standard of 90% of cases. Almost all endoscopists correctly used Prague and Los Angeles classifications (87.8% and 98.2%, respectively), as well as Seattle and Management of precancerous conditions and lesions in the stomach (MAPS) biopsy protocols (86.5% and 91.4%, respectively). However, only 52.8% of participants monitored complications after therapeutic EGD, and 40.8% recorded patients with a diagnosis of Barrett's esophagus (BE). With regard to colonoscopy, almost all endoscopists (93.9%) used the Boston Bowel Preparation Scale for measuring bowel preparation quality and reported a cecal intubation rate ≥90%. However, about a quarter (26.2%) of participants reported an adenoma detection rate of <25%, only 52.8% applied an appropriate polypectomy technique, 48% monitored complications after the procedure, and 12.4% measured patient's experience.ConclusionThe adherence of endoscopists to ESGE performance measures for GI endoscopy is sub-optimal in Italy. There is a need to disseminate and implement performance measures and endorse educational and scientific interventions on the quality of endoscopy.

Dataset Information

Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy.

Publications

Endoscopy works during the pandemic of coronavirus COVID-19: recommendations by the Chinese Society of Digestive Endoscopy.

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