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Endoscopy in inflammatory bowel diseases during the COVID-19 pandemic and post-pandemic period
Marietta Iacucci1, Rosanna Cannatelli2, Nunzia Labarile3
1Institute of Translational of Medicine, Institute of immunology and immunotherapy and NIHR Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, UK; Department of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada.
Insights
The COVID-19 pandemic impacts inflammatory bowel disease (IBD) patient care, suspending routine endoscopy. This guidance outlines urgent endoscopy scenarios, safety protocols, and post-pandemic access plans for IBD patients.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic has disrupted standard medical procedures globally.
- Patients with inflammatory bowel diseases (IBD) require ongoing management, often involving endoscopic procedures.
- Restrictions on routine endoscopy due to SARS-CoV-2 necessitate revised clinical guidelines.
Purpose of the Study:
- To provide guidance on urgent endoscopic procedures for IBD patients during the COVID-19 pandemic.
- To recommend personal protective equipment (PPE) and safe endoscopy pathways.
- To discuss the risks of delaying IBD endoscopy and propose a post-pandemic strategy.
Main Methods:
- Review of current clinical practices and literature regarding IBD management during pandemics.
- Development of a decision-making pathway for urgent endoscopy in IBD.
- Formulation of recommendations for PPE and infection control during endoscopy.
Main Results:
- Identification of specific clinical scenarios warranting urgent endoscopy in IBD patients.
- Guidelines for the appropriate use of PPE to minimize SARS-CoV-2 transmission.
- Discussion of potential adverse outcomes associated with postponed endoscopic evaluations.
Conclusions:
- Urgent endoscopy in IBD patients is crucial in specific situations during the COVID-19 pandemic.
- Implementing safe endoscopy protocols and appropriate PPE is essential for patient and healthcare worker safety.
- A structured post-pandemic plan is needed to address the backlog and ensure continued access to essential endoscopic care for IBD.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic is changing the management of many chronic diseases, including that of patients with inflammatory bowel diseases (IBD). In particular, the performance of routine endoscopy is temporarily suspended, and only emergency endoscopy is allowed in many countries where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread. We highlight different scenarios in which endoscopy should still be performed urgently in patients with IBD, as well as recommendations regarding the use of personal protective equipment. We suggest a pathway for performing safe endoscopy and discuss the potential risks of postponing endoscopy in IBD. Finally, we propose a post-pandemic plan for access to endoscopy.
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