Evaluation of Children Undergoing Endoscopic Procedures During the Normalization of the Coronavirus Disease 2019 Pandemic
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Published on: November 7, 2020
Şenay Onbaşı Karabağ1, Maşallah Baran2, Betül Aksoy1
1Department of Pediatric Gastroenterology, Hepatology and Nutrition, SBU Tepecik Training and Research Hospital, izmir, Turkey.
Insights
Pediatric endoscopy units can safely perform procedures without negative-pressure rooms. This study found no coronavirus disease 2019 cases in children undergoing gastrointestinal endoscopy with appropriate protective measures.
Area of Science:
- Gastroenterology
- Pediatric Endoscopy
- Infectious Disease Control
Background:
- Gastrointestinal endoscopy procedures pose high risks for aerosol formation and infection transmission.
- Coronavirus disease 2019 (COVID-19) pandemic necessitated reorganization of endoscopy units, emphasizing negative-pressure rooms and personal protective equipment (PPE).
- Alternative protocols are needed for endoscopy units lacking negative-pressure facilities during pandemic normalization.
Purpose of the Study:
- To evaluate the safety of pediatric endoscopy procedures performed without negative-pressure chambers.
- To assess the incidence of coronavirus disease 2019 (COVID-19) in pediatric patients undergoing endoscopy during pandemic normalization.
Main Methods:
- Prospective evaluation of pediatric patients undergoing gastrointestinal endoscopy.
- Patients were monitored for COVID-19 symptoms and exposure before and 7 and 14 days after procedures.
- Data collected on procedure type, location, and patient demographics.
Main Results:
- Seventy-eight procedures were performed on 69 pediatric patients (mean age 12.0 ± 5.1 years).
- Upper gastrointestinal endoscopy (69.2%) and colonoscopy (30.8%) were conducted.
- No instances of COVID-19 symptoms or infection were detected in any patients.
Conclusions:
- Endoscopic procedures can be safely conducted in pediatric units without negative-pressure rooms.
- Appropriate personal protective equipment and rigorous patient screening are crucial for safety.
- This approach allows for continued essential endoscopic care during public health crises.
Background:
Given that procedures involving gastrointestinal tract lumens are high-risk and aerosol forming, the functioning of endos- copy units has been reorganized during the coronavirus disease 2019 pandemic. Guidelines recommend that all personnel should carry out procedures in a negative-pressure room with personal protective equipment; in the absence of a negative-pressure room, an ade- quately ventilated room should be used. During the normalization of the coronavirus disease 2019 pandemic, this study aimed to evalu- ate children who were treated in our endoscopy unit without a negative-pressure chamber in terms of coronavirus disease 2019 after procedures.
Methods:
Patients were questioned and evaluated prospectively for symptoms and contact with coronavirus disease 2019 patients on before and 7th and 14th days after the procedure.
Results:
Seventy-eight procedures were performed on 69 patients over a 3-month period. The mean age of patients was 12.0 ± 5.1 years. Among all the procedures performed, 54 (69.2%) involved upper gastrointestinal system (GIS) endoscopy and 24 (30.8%) involved colo- noscopy. Furthermore, 72 (91.3%) of the procedures were performed in the pediatric endoscopy unit, and 6 (7.7%) were performed in the operating room. No coronavirus disease 2019 symptoms or presence was detected in the patients.
Conclusion:
The ideal setting for an endoscopic procedure is in a negative-pressure chamber. However, this study has shown that endoscopic procedures can be performed in units without negative-pressure rooms but with appropriate protective equipment and evaluation of patients for coronavirus disease 2019 symptoms.
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