Clinical Endoscopy

Polyposis of gastrointestinal tract after COVID-19 mRNA vaccination: a report of two cases: Jun Ho Kim, Eun Hye Oh, Dong Soo Han; Clin Endosc 2024;57(3):402-406. Published online April 12, 2024; DOI: https://doi.org/10.5946/ce.2023.268

Cronkhite-Canada syndrome is a rare gastrointestinal polyposis syndrome with distinctive clinical features and endoscopic findings. Diagnosis can be challenging without suspicion, and the disease carries high mortality due to complications such as infection, gastrointestinal bleeding, and malignancies. This paper presents two cases of Cronkhite-Canada syndrome occurring after coronavirus disease 2019 (COVID-19) mRNA vaccination. Both cases exhibited typical clinical findings, including hypogeusia, onychodystrophy, alopecia, and weight loss. Typical polyposis in the gastrointestinal tract was confirmed through endoscopies. As symptomatic treatment did not improve the symptoms, corticosteroids were administered, and symptoms and laboratory test results improved immediately. The patients improved upon corticosteroids tapering. These cases illustrate typical presentations of Cronkhite-Canada syndrome and the course of the disease following corticosteroid treatment. Additionally, they suggest the possibility that Cronkhite-Canada syndrome may be triggered by COVID-19 mRNA vaccination.

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Elasomeran/tozinameran

Reactions Weekly.2024; 2015(1): 165. CrossRef

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Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial: Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Varut Lohsiriwat, Vitoon Chinswangwatanakul; Clin Endosc 2024;57(3):335-341. Published online June 21, 2023; DOI: https://doi.org/10.5946/ce.2023.018

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: The coronavirus disease 2019 pandemic has affected the worldwide practice of upper gastrointestinal endoscopy. Here we designed a modified N95 respirator with a channel for endoscope insertion and evaluated its efficacy in upper gastrointestinal endoscopy.
Methods
Thirty patients scheduled for upper gastrointestinal endoscopy were randomized into the modified N95 (n=15) or control (n=15) group. The mask was placed on the patient after anesthesia administration and particles were counted every minute before (baseline) and during the procedure by a TSI AeroTrak particle counter (9306-04; TSI Inc.) and categorized by size (0.3, 0.5, 1, 3, 5, and 10 µm). Differences in particle counts between time points were recorded.
Results
During the procedure, the modified N95 group displayed significantly smaller overall particle sizes than the control group (median [interquartile range], 231 [54–385] vs. 579 [213–1,379]×103/m3; p=0.056). However, the intervention group had a significant decrease in 0.3-µm particles (68 [–25–185] vs. 242 [72–588]×103/m3; p=0.045). No adverse events occurred in either group. The device did not cause any inconvenience to the endoscopists or patients.
Conclusions
This modified N95 respirator reduced the number of particles, especially 0.3-µm particles, generated during upper gastrointestinal endoscopy.

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Management of aerosol generation during upper gastrointestinal endoscopy: Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn, Thawatchai Akaraviputh; Clin Endosc 2022;55(5):588-593. Published online August 24, 2022; DOI: https://doi.org/10.5946/ce.2022.062

Abstract PDF PubReader ePub

In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

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Aerosol protection using modified N95 respirator during upper gastrointestinal endoscopy: a randomized controlled trial
Chawisa Nampoolsuksan, Thawatchai Akaraviputh, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanakorn,
Clinical Endoscopy.2024; 57(3): 335. CrossRef
Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019
Shahnaz Sultan
Gastroenterology Clinics of North America.2023; 52(1): 157. CrossRef
Does an Extraoral Suction Device Reduce Aerosol Generation and Prevent Droplet Exposure to the Examiner during Esophagogastroduodenoscopy?
Shintaro Fujihara, Hideki Kobara, Noriko Nishiyama, Naoya Tada, Yasuhiro Goda, Kazuhiro Kozuka, Takanori Matsui, Taiga Chiyo, Nobuya Kobayashi, Tatsuo Yachida, Tsutomu Masaki
Journal of Clinical Medicine.2023; 12(7): 2574. CrossRef

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Impact of the COVID-19 Outbreak on Anesthesiologist Assistance for Endoscopic Procedures: Calcedonio Calcara, Camilla Ciscato, Arnaldo Amato, Emanuele Sinagra, Costanza Alvisi, Sandro Ardizzone, Andrea Anderloni, Pietro Gambitta, on behalf of the FISMAD Lombardy COVID-19 Impact on Anesthesiologist-Assisted Endoscopy Study Group; Clin Endosc 2022;55(1):49-57. Published online January 27, 2022; DOI: https://doi.org/10.5946/ce.2021.191

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The coronavirus disease 2019 (COVID-19) outbreak has modified the activities of endoscopy units worldwide. Herein, we investigated the impact of the COVID-19 outbreak on anesthesiologist assistance for endoscopic procedures in Lombardy, Italy.
Methods
A questionnaire concerning anesthesiologist assistance provided from October 26 to December 6, 2020, in comparison with the same period in 2019, was sent to endoscopic units in Lombardy.
Results
Approximately 54% (34/63) of the units responded. A reduction in the number of all endoscopies (-33.5%; 18792 in 2020 vs. 28264 in 2019) and anesthesiologist-assisted endoscopies (-15.3%; 2652 in 2020 vs. 3132 in 2019) was reported. A greater reduction in anesthesiologist assistance was observed in government community units (-29.5%) than in academic (-14%) and private community units (-4.6%). Among all units, 85% reported a reduction in anesthesiologist assistance; 65% observed a delay/cancellation of procedures; 59%, a restricted patient selection; 17%, the need to transfer some patients to other hospitals; and 32%, a related worsening of procedure quality.
Conclusion
The COVID-19 pandemic compromised the anesthesiologist assistance for endoscopic procedures in Lombardy, which worsened the procedure quality mainly in government community units. The COVID-19 “stress test” suggests a more balanced allocation of anesthesiologic resources in the future.

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COVID-19 and the Pancreas: A Narrative Review
Emanuele Sinagra, Endrit Shahini, Federica Crispino, Ina Macaione, Valentina Guarnotta, Marta Marasà, Sergio Testai, Socrate Pallio, Domenico Albano, Antonio Facciorusso, Marcello Maida
Life.2022; 12(9): 1292. CrossRef

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Preclinical Efficacy and Clinical Feasibility of a Novel Aerosol-Exposure Protection Mask for Esophagogastroduodenoscopy: Mai Ego Makiguchi, Seiichiro Abe, Yutaka Okagawa, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Ichiro Oda, Okamoto Ryuta, Yutaka Saito; Clin Endosc 2022;55(2):226-233. Published online December 15, 2021; DOI: https://doi.org/10.5946/ce.2021.178-IDEN

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: This study aimed to assess the efficacy of a novel aerosol-exposure protection (AP) mask in preventing coronavirus disease in healthcare professionals during upper gastrointestinal endoscopy and to evaluate its clinical feasibility.
Methods
In Study 1, three healthy volunteers volitionally coughed with and without the AP mask in a cleanroom. Microparticles were visualized and counted with a specific measurement system and compared with and without the AP mask. In Study 2, 30 patients underwent endoscopic resection with the AP mask covering the face, and the SpO2 was measured throughout the procedure.
Results
In Study 1, the median number of microparticles in volunteers 1, 2, and 3 with and without the AP mask was 8.5 and 110.0, 7.0 and 51.5, and 8.0 and 95.0, respectively (p<0.01). Using the AP mask, microparticles were reduced by approximately 92%. The median distances of microparticle scattering without the AP mask were 60, 0, and 68 in volunteers 1, 2, and 3, respectively. In Study 2, the mean SpO2 was 96.3%, and desaturation occurred in three patients.
Conclusion
The AP mask could provide protection from aerosol exposure and can be safely used for endoscopy in clinical practice.

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Aerosol and Droplet Dispersion Control during Bronchoscopy Using a Newly Developed Oxygen Mask
Yuki Nagamatsu, Masatoshi Kakihana, Yujin Kudo, Wakako Hamanaka, Yohei Kawaguchi, Yuki Yamada, Chiaki Kanno, Sachio Maehara, Masaru Hagiwara, Tatsuo Ohira, Norihiko Ikeda
Respiratory Endoscopy.2024; 2(1): 25. CrossRef
A Novel Aerosol-Exposure Protection Mask for Patients During Upper Endoscopy
Soo-Jeong Cho
Clinical Endoscopy.2022; 55(2): 208. CrossRef

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Impact of COVID-19 on Endoscopy Training: Perspectives from a Global Survey of Program Directors and Endoscopy Trainers: Shivakumar Vignesh, Amna Subhan Butt, Mohamed Alboraie, Bruno Costa Martins, Alejandro Piscoya, Quang Trung Tran, Damien Tan Meng Yew, Shahriyar Ghazanfar, Pezhman Alavinejad, Edna Kamau, Ajay M Verma, Robin B Mendelsohn, Christopher Khor, Alan Moss, David Wei Chih Liao, Christopher S Huang, Franklin C Tsai; Clin Endosc 2021;54(5):678-687. Published online September 30, 2021; DOI: https://doi.org/10.5946/ce.2021.140

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical trainees internationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective of endoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education.
Methods
Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-based survey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopy training, including what factors decisions were based on.
Results
The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training, with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with European programs reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americas were allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support for endoscopy teaching.
Conclusions
This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopy training internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competencies are necessary to ensure adequate endoscopy training.

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Telementoring for endoscopic submucosal dissection in vivo training
Hon Chi Yip, Noriya Uedo, Louis Ho‐Shing Lau, Daizen Hirata, Yasushi Sano, Philip Wai‐yan Chiu
Digestive Endoscopy.2023; 35(1): 140. CrossRef
Gastrointestinal Bleeding in COVID-19-Infected Patients
Mitchell S. Cappell, David M. Friedel
Gastroenterology Clinics of North America.2023; 52(1): 77. CrossRef
Simulator-based training method in gastrointestinal endoscopy training and currently available simulators
Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung
Clinical Endoscopy.2023; 56(1): 1. CrossRef
Endoscopy After the COVID-19 Pandemic—What Will Be Different?
Rashid N. Lui, Raymond S. Y. Tang, Philip W. Y. Chiu
Current Treatment Options in Gastroenterology.2022; 20(1): 46. CrossRef
A Simulation Study to Investigate the Usefulness of a Novel Stricture Tool for Training Wire Guided Balloon Dilation
Avinash Bhat Balekuduru, Manoj K. Sahu
Journal of Digestive Endoscopy.2022; 13(03): 141. CrossRef

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Perception of Gastrointestinal Endoscopy Personnel on Society Recommendations on Personal Protective Equipment, Case Selection, and Scope Cleaning During Covid-19 Pandemic: An International Survey Study: Parit Mekaroonkamol, Kasenee Tiankanon, Rapat Pittayanon, Wiriyaporn Ridtitid, Fariha Shams, Ghias Un Nabi Tayyab, Julia Massaad, Saurabh Chawla, Stanley Khoo, Siriboon Attasaranya, Nonthalee Pausawasdi, Qiang Cai, Thawee Ratanachu-ek, Pradermchai Kongkham, Rungsun Rerknimitr; Clin Endosc 2022;55(2):215-225. Published online September 29, 2021; DOI: https://doi.org/10.5946/ce.2021.051

Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them.
Methods
A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables.
Results
Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039).
Conclusions
Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

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Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis: Umair Iqbal, Hafsa Anwar, Hafiz Umair Siddiqui, Muhammad Ali Khan, Faisal Kamal, Bradley D. Confer, Harshit S. Khara; Clin Endosc 2021;54(4):534-541. Published online June 25, 2021; DOI: https://doi.org/10.5946/ce.2021.071

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB).
Methods
A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB.
Results
Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%).
Conclusions
The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

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Prevalence and outcomes of upper gastrointestinal bleeding in COVID‐19: A systematic review and meta‐analysis
Sawai Singh Rathore, Zario Shai Wint, Aman Goyal, Bijay Mukesh Jeswani, Ameer Mustafa Farrukh, María Alejandra Nieto‐Salazar, Thanmai Reddy Thugu, Snigdha Erva, Raafay Mehmood, Adriana Carolina Toro‐velandia, Hamam Aneis, Sunny Ratnani, Ibrahim Marouf Yas
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Baylor University Medical Center Proceedings.2024; 37(2): 239. CrossRef
Increasing inpatient mortality of nonvariceal upper gastrointestinal bleeding during the COVID-19 pandemic: a nationwide retrospective cohort study
Waqas Rasheed, Gnanashree Dharmarpandi, Ola Al-Jobory, Anass Dweik, Muhammad Anil, Sameer Islam
Baylor University Medical Center Proceedings.2023; 36(3): 286. CrossRef
Outcomes in Patients Admitted for Upper Gastrointestinal Bleeding and COVID-19 Infection: A Study of Two Years of the Pandemic
Sergiu Cazacu, Daniela Burtea, Vlad Iovănescu, Dan Florescu, Sevastița Iordache, Adina Turcu-Stiolica, Victor Sacerdotianu, Bogdan Ungureanu
Life.2023; 13(4): 890. CrossRef
Prevalence, causes, medical interventions, and mortality outcome of acute gastrointestinal bleeding among COVID-19 inpatients
Mai N. Luu, Thinh P. Dang, Minh-Cong H. Vo, Duc T. Quach
Current Medical Research and Opinion.2023; 39(5): 731. CrossRef
Gastrointestinal Bleeding in Patients With New Coronavirus Infection COVID-19
V. D. Anosov, S. A. Domrachev, S. V. Ovchinnikov, N. O. Solovyov
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Hassan Ashktorab, Tiziano Russo, Gholamreza Oskrochi, Giovanni Latella, Sara Massironi, Martina Luca, Lakshmi G. Chirumamilla, Adeyinka O. Laiyemo, Hassan Brim
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Clinical Characteristics of Hospitalized COVID-19 Patients Who Have Gastrointestinal Bleeds Requiring Intervention: A Case-Control Study
Ahmad Abulawi, Ali Al-Tarbsheh, Annie Leamon, Paul Feustel, Amit Chopra, Asra Batool
Cureus.2022;[Epub] CrossRef
Clinical features of thrombosis and bleeding in COVID-19
Mari R. Thomas, Marie Scully
Blood.2022; 140(3): 184. CrossRef
Mortality Rate in Upper Gastrointestinal Bleeding Associated with Anti-Thrombotic Therapy Before and During Covid-19 Pandemic
Petrica Popa, Sevastita Iordache, Dan Nicolae Florescu, Vlad Florin Iovanescu, Alexandru Vieru, Valentin Barbu, Maria-Cristina Bezna, Dragos Ovidiu Alexandru, Bogdan Silviu Ungureanu, Sergiu Marian Cazacu
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Coronavirus Disease in the Abdomen
Mark A. Anderson, Mark A. Khauli, Reece J. Goiffon, Avinash Kambadakone
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Сauses, risk factors, diagnostics and treatment of gastrointestinal bleeding in patients with a novel coronavirus infection (COVID-19)
A. A. Sheptulin, S. S. Kardasheva, A. A. Kurbatova
Clinical Medicine (Russian Journal).2022; 100(7-8): 341. CrossRef
The frequency of ulcerative-erosive defects and ulcerative bleeding of the gastroduodenal zone in patients with coronavirus infection COVID-19
N. N. Butorin, V. V. Tsukanov, R. V. Asyayev, M. N. Butorina, A. V. Vasyutin, J. L. Tonkikh
Experimental and Clinical Gastroenterology.2022; (5): 5. CrossRef

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“Endoshield”: A Physical Protective Box for Pediatric Endoscopy during the COVID-19 Pandemic: Busara Charoenwat, Suphasarang Sirirattanakul, Kangsadan Hangnak, Itsares Muikham; Clin Endosc 2021;54(5):688-693. Published online April 1, 2021; DOI: https://doi.org/10.5946/ce.2021.082

Abstract PDF PubReader ePub

Background
/Aims: The coronavirus disease (COVID)-19 pandemic presents challenges for gastrointestinal endoscopy. Although the virus is transmitted through contact and droplets, aerosol-generating procedures produce aerosols that can spread through airborne routes. Several gastrointestinal societies have released statements to protect patients and health care providers (HCPs). This study describes a barrier box that may be used as an adjunctive device in addition to personal protective equipment during endoscopies.
Methods
A transparent acrylic box called “Endoshield” was created to place over patient’s head and shoulders and was tested for its ease of use for the endoscopist and suitability for patient size and position.
Results
Twelve children (66.67%, male) with a median age of 9 years (range, 2–11 years) underwent emergency or urgent endoscopy between April and June 2020 during the COVID-19 outbreak. The most common presenting symptom was life-threatening gastrointestinal bleeding (8/12, 66.67%), while the rest had urgent symptoms (4/12, 33.33%). The “Endoshield” was suitable for all patient positions (left lateral position: 9/12, 75% and supine position: 3/12, 25%). The patients and HCPs were followed up for their symptoms on day 14, and none of them had any symptoms of concern.
Conclusions
The “Endoshield” is affordable, reusable, and suitable for both positions.

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A Novel Aerosol-Exposure Protection Mask for Patients During Upper Endoscopy
Soo-Jeong Cho
Clinical Endoscopy.2022; 55(2): 208. CrossRef
Simple and innovative methods of minimizing risk of aerosol generation during endoscopy
Sumitro Kosasih, Adli Metussin, Norwani Basir, Vui Heng Chong
Clinical Endoscopy.2022; 55(3): 470. CrossRef
Management of aerosol generation during upper gastrointestinal endoscopy
Chawisa Nampoolsuksan, Vitoon Chinswangwatanakul, Asada Methasate, Jirawat Swangsri, Atthaphorn Trakarnsanga, Chainarong Phalanusitthepha, Thammawat Parakonthun, Voraboot Taweerutchana, Nicha Srisuworanan, Tharathorn Suwatthanarak, Thikhamporn Tawantanako
Clinical Endoscopy.2022; 55(5): 588. CrossRef
Biopsy channel of the endoscope as a potential source of infectious droplets during GI endoscopy
Mark F. Coughlan, Mandeep S. Sawhney, Douglas K. Pleskow, Umar Khan, Andy Silva-Santisteban, Awais Ahmed, Xuejun Zhang, Maria Glyavina, Liming Chen, Paul K. Upputuri, Yuri N. Zakharov, Lei Zhang, Le Qiu, Lev T. Perelman
Gastrointestinal Endoscopy.2022; 96(5): 764. CrossRef

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COVID-19 Rapid Antigen Test: Role in Screening Prior to Gastrointestinal Endoscopy: Ashok Dalal, Ujjwal Sonika, Manish Kumar, Roshan George, Ajay Kumar, Siddharth Srivastava, Sanjeev Sachdeva, Barjesh Chander Sharma; Clin Endosc 2021;54(4):522-525. Published online March 4, 2021; DOI: https://doi.org/10.5946/ce.2020.295

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Background
/Aims: The severe acute respiratory syndrome coronavirus 2 pandemic has affected the gastrointestinal (GI) endoscopy units globally owing to the risk of transmission. We present our data on the use of rapid antigen test (RAT) as a screening tool prior to endoscopy to prevent the transmission of coronavirus disease (COVID-19).
Methods
This study was a retrospective analysis of patients who underwent any GI endoscopic procedure from July 2020 to October 2020 at a tertiary referral center in New Delhi, India. All patients underwent screening for COVID-19 using RAT, and endoscopy was performed only when the RAT was negative. The data are presented as numbers and percentages.
Results
A total of 3,002 endoscopic procedures were performed during the study period. Only one endoscopic procedure was performed in a COVID-19 positive patient. A total of 53 healthcare workers were involved in conducting these procedures. Only 2 healthcare workers (3.8%) were diagnosed COVID-19 positive, presumably due to community-acquired infection, during this period.
Conclusions
The COVID-19 RAT is easily usable as a simple screening tool prior to GI endoscopy during the COVID-19 pandemic.

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Intestinal Damage, Inflammation and Microbiota Alteration during COVID-19 Infection
Angela Saviano, Mattia Brigida, Carmine Petruzziello, Christian Zanza, Marcello Candelli, Maria Rita Morabito Loprete, Faiz Saleem, Veronica Ojetti
Biomedicines.2023; 11(4): 1014. CrossRef
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Marouf Alhalabi, Kamal Alaa Eddin, Fadwa Ali, Ahmad Abbas
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Song Lee Kim
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Jacqueline Dinnes, Pawana Sharma, Sarah Berhane, Susanna S van Wyk, Nicholas Nyaaba, Julie Domen, Melissa Taylor, Jane Cunningham, Clare Davenport, Sabine Dittrich, Devy Emperador, Lotty Hooft, Mariska MG Leeflang, Matthew DF McInnes, René Spijker, Jan Y
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Risk-based decision-making related to preprocedural coronavirus disease 2019 testing in the setting of GI endoscopy: management of risks, evidence, and behavioral health economics
Naomi Moy, Uwe Dulleck, Ayesha Shah, Helmut Messmann, Aaron P. Thrift, Nicholas J. Talley, Gerald J. Holtmann
Gastrointestinal Endoscopy.2022; 96(5): 735. CrossRef

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Clinical Gastroenterology and Gastrointestinal Endoscopy Practices during the Coronavirus Disease 2019 Pandemic in Indonesia: An Online Nationwide Survey: Ahmad Fariz Malvi Zamzam Zein, Rabbinu Rangga Pribadi, Uswatun Khasanah, Muhammad Begawan Bestari, Ari Fahrial Syam; Clin Endosc 2021;54(3):348-355. Published online February 18, 2021; DOI: https://doi.org/10.5946/ce.2020.216

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Background
/Aims: The coronavirus disease 2019 (COVID-19) pandemic has necessitated modifications to allow the safe practice of clinical gastroenterology and gastrointestinal endoscopy. This study aimed to investigate the characteristics of clinical gastroenterology and gastrointestinal endoscopy practices during the COVID-19 pandemic in Indonesia.
Methods
This cross-sectional study enrolled physician members of the Indonesian Society for Digestive Endoscopy. We used an online self-administered questionnaire disseminated via social media. The 32-item survey determined the baseline characteristics of the participants, characteristics of clinical gastroenterology and gastrointestinal endoscopy practices, involvement of the physicians in the management of COVID-19, and overall impact of the pandemic on practice. All collected data were analyzed using descriptive statistics.
Results
The 200 participants in this study had a median age of 50 (34–76) years. Modifications in clinical gastroenterology practice were frequently reported in the outpatient (95.5%) and inpatient (100%) settings. All participants reported changes in the gastrointestinal endoscopy practice patterns. Of the participants, 86.0% were working in high-risk zones, and several of them reported inadequate protective personal equipment (34.0%). The median overall impact score of the pandemic on practice was 9 (2–10).
Conclusions
Physicians practicing clinical gastroenterology and gastrointestinal endoscopy in Indonesia work in high-risk settings. Modifications in clinical gastroenterology and gastrointestinal endoscopy practices are prevalent during the COVID-19 pandemic.

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Impact of the COVID-19 pandemic on digestive endoscopists: an Ibero-American study
Robin German Prieto-Ortiz, Camilo de Jesús Blanco-Avellaneda, Ricardo Cepeda-Vásquez, Diana Yanira Chimbi Rojas, Jhon Edison Prieto-Ortiz, Leticia Moreira-Ruiz, Lázaro Antonio Arango-Molano
Revista Española de Enfermedades Digestivas.2022;[Epub] CrossRef
Clinical Practice of Gastrointestinal Endoscopy in COVID-19 Patients: An Experience from Indonesia
Rabbinu Rangga Pribadi, Amanda Pitarini Utari, Virly Nanda Muzellina, Saskia Aziza Nursyirwan, Hasan Maulahela, Kaka Renaldi, Ari Fahrial Syam
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Changes in Policy and Endoscopic Procedures during the 2019 Coronavirus Disease Outbreak: A Single Center Experience: Adi Lahat, Avidan Benjamin; Clin Endosc 2021;54(1):48-54. Published online November 6, 2020; DOI: https://doi.org/10.5946/ce.2020.132

Abstract PDF PubReader ePub

Background
/Aims: The coronavirus disease-19 (COVID-19) pandemic forced endoscopy units to enact major changes on daily practice and policy. The Chaim Sheba Medical Center is a tertiary referral center located in the center of Israel, and serves cities with high infection rates. Our aim was to review the policies enacted during this outbreak and study their influence on the performance of endoscopic procedures.
Methods
Following the revision of work protocols, personnel were divided into two permanent and physically separate working groups and screening procedures were rescheduled. Relevant data including the number of endoscopic examinations, type of procedure performed, and patient referrals and indications were taken from a computerized database and evaluated. The study included data for January–March 2018–2020, and a comparison among the data from each year was performed.
Results
As of March 2020, the total number of endoscopic examinations performed reduced by 44% (p<0.0001) as compared to previous years, gastroscopy examinations reduced by 39% (p=0.02), and lower endoscopy procedures reduced by 57% (p<0.0001). Meanwhile, the number of advanced endoscopic procedures performed remained consistent with previous years. The indications for performance of gastroscopy and lower endoscopy were different in March 2020, while these remained unchanged for advanced endoscopic procedures.
Conclusions
The current policy appears to serve both our initial goals: protecting personnel and patients’ safety and minimizing potential damage from delayed endoscopic procedures. A longer term follow-up study is needed in order to fully analyze our results.

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