Approach to Endoscopic Procedures: A Routine Protocol from a Quaternary University Referral Center Exclusively for Coronavirus Disease 2019 Patients

Authors

  • Tomazo Antonio Prince Franzini Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Gastroenterologia https://orcid.org/0000-0002-5477-4939
  • Ana Paula Samy Tanaka Kotinda Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Gastroenterologia https://orcid.org/0000-0002-2915-8974
  • Diogo Turiani Hourneaux de Moura Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Gastroenterologia https://orcid.org/0000-0002-7446-0355
  • Márcia Lopes Vicente Badana Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Marion Sielfeld de Medeiros Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Patrícia Goulart Rodrigues Lima Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Brigitte Feiner de Mello Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Rafael Priante Kayano Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Maria José Carvalho Carmona Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas
  • Marcelo Cristiano Rocha Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas https://orcid.org/0000-0001-6821-2286
  • Aléia Faustina Campos Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas https://orcid.org/0000-0002-3244-5237
  • Thomas R. McCarty Harvard Medical School, Brigham and Women’s Hospital, Division of Gastroenterology, Hepatology and Endoscopy https://orcid.org/0000-0003-4517-5261
  • Thaı´s Guimarães Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas https://orcid.org/0000-0002-7282-5453
  • Maria Luisa do Nascimento Moura Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas https://orcid.org/0000-0003-1013-8233
  • Christopher C. Thompson Harvard Medical School, Brigham and Women’s Hospital, Division of Gastroenterology, Hepatology and Endoscopy https://orcid.org/0000-0002-6105-5270
  • Eduardo Guimarães Hourneaux de Moura Universidade de Sao Paulo, Faculdade de Medicina, Hospital das Clinicas, Departamento de Gastroenterologia https://orcid.org/0000-0002-8023-3722

DOI:

https://doi.org/10.6061/clinics/2020/e1989

Keywords:

COVID-19, Endoscopy, Coronavirus, SARS-CoV-2

Abstract

OBJECTIVES: The present coronavirus disease (COVID-19) pandemic has ushered in an unprecedented era of quality control that has necessitated advanced safety precautions and the need to ensure the adequate protection of healthcare professionals (HCPs). Endoscopy units, endoscopists, and other HCP may be at a significant risk for transmission of the virus. Given the immense burden on the healthcare system and surge in the number of patients with COVID-19, well-designed protocols and recommendations are needed. We aimed to systematically characterize our approach to endoscopic procedures in a quaternary university hospital setting and provide summary protocol recommendations. METHOD: This descriptive study details a COVID-19-specific protocol designed to minimize infection risks to patients and healthcare workers in the endoscopy unit. RESULTS: Our institution, located in Sa˜o Paulo, Brazil, includes a 900-bed hospital, with a 200-bed-specific intensive care unit exclusively designed for patients with moderate and severe COVID-19. We highlighted recommendations for infection prevention and control during endoscopic procedures, including appropriate triage and screening, outpatient management and procedural recommendations, role and usage of personal protective equipment (PPE), and role and procedural logistics involving COVID-19-positive patients. We also detailed hospital protocols for reprocessing endoscopes and cleaning rooms and also provided recommendations to minimize severe acute respiratory syndrome coronavirus 2 transmission. CONCLUSION: This COVID-19-specific administrative and clinical protocol can be replicated or adapted in multiple institutions and endoscopy units worldwide. Furthermore, the recommendations and summary protocol may improve patient and HCP safety in these trying times.

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Published

2020-06-20

How to Cite

Franzini, T. A. P., Kotinda, A. P. S. T., Moura, D. T. H. de, Badana, M. L. V., Medeiros, M. S. de, Lima, P. G. R., Mello, B. F. de, Kayano, R. P., Carmona, M. J. C., Rocha, M. C., Campos, A. F., McCarty, T. R., Guimarães, T., Moura, M. L. do N., Thompson, C. C., & Moura, E. G. H. de. (2020). Approach to Endoscopic Procedures: A Routine Protocol from a Quaternary University Referral Center Exclusively for Coronavirus Disease 2019 Patients. Clinics, 75, e1989. https://doi.org/10.6061/clinics/2020/e1989

Issue

Section

Original Articles