Changes in Policy and Endoscopic Procedures during the 2019 Coronavirus Disease Outbreak: A Single Center Experience
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Background/Aims: The coronavirus disease-19 (COVID-19) pandemic forced endoscopy units to enact major changes on dailypractice and policy. The Chaim Sheba Medical Center is a tertiary referral center located in the center of Israel, and serves cities withhigh infection rates. Our aim was to review the policies enacted during this outbreak and study their influence on the performanceof endoscopic procedures. Methods: Following the revision of work protocols, personnel were divided into two permanent and physically separate workinggroups and screening procedures were rescheduled. Relevant data including the number of endoscopic examinations, type ofprocedure performed, and patient referrals and indications were taken from a computerized database and evaluated. The studyincluded 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 toprevious 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 indicationsfor performance of gastroscopy and lower endoscopy were different in March 2020, while these remained unchanged for advancedendoscopic procedures. Conclusions: The current policy appears to serve both our initial goals: protecting personnel and patients’ safety and minimizingpotential damage from delayed endoscopic procedures. A longer term follow-up study is needed in order to fully analyze our results.
Abstract
Background/Aims: The coronavirus disease-19 (COVID-19) pandemic forced endoscopy units to enact major changes on dailypractice and policy. The Chaim Sheba Medical Center is a tertiary referral center located in the center of Israel, and serves cities withhigh infection rates. Our aim was to review the policies enacted during this outbreak and study their influence on the performanceof endoscopic procedures. Methods: Following the revision of work protocols, personnel were divided into two permanent and physically separate workinggroups and screening procedures were rescheduled. Relevant data including the number of endoscopic examinations, type ofprocedure performed, and patient referrals and indications were taken from a computerized database and evaluated. The studyincluded 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 toprevious 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 indicationsfor performance of gastroscopy and lower endoscopy were different in March 2020, while these remained unchanged for advancedendoscopic procedures. Conclusions: The current policy appears to serve both our initial goals: protecting personnel and patients’ safety and minimizingpotential damage from delayed endoscopic procedures. A longer term follow-up study is needed in order to fully analyze our results.
참고문헌 (29)
- "Pneumonia of unknown cause – China" (2020)[URL]
- "WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020" (2020)[URL]
- "Diagnosis and treatment of new coronavirus pneumonia (version 5)" (2020)[URL]
- Chan JF, "A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission : a study of a family cluster", Lancet, 395, pp.514~523 (2020)
- Guan WJ, "Clinical characteristics of coronavirus disease 2019 in China", N Engl J Med, 382, pp.1708~1720 (2020)
- Hajifathalian K, "SARS-COV-2 infection(coronavirus disease 2019)for the gastrointestinal consultant", World J Gastroenterol, 26, pp.1546~1553 (2020)
- Patel KP, "Gastrointestinal, hepatobiliary, and pancreatic manifestations of COVID-19", J Clin Virol, 128, pp.104386~ (2020)
- Li Q, "Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia", N Engl J Med, 382, pp.1199~1207 (2020)
- Yeo C, "Enteric involvement of coronaviruses : is faecal-oral transmission of SARS-CoV-2 possible?", Lancet Gastroenterol Hepatol, 5, pp.335~337 (2020)
- Johnston ER, "Risk of bacterial exposure to the endoscopist’s face during endoscopy", Gastrointest Endosc, 89, pp.818~824 (2019)
- Bai Y, "Presumed asymptomatic carrier transmission of COVID-19", JAMA, 323, pp.1406~1407 (2020)
- Rothe C, "Transmission of 2019-nCoV infection from an asymptomatic contact in Germany", N Engl J Med, 382, pp.970~971 (2020)
- "Italy reports nearly 6,000 new cases of coronavirus and more than 600 deaths in the past 24 hours" (2020)[URL]
- Repici A, "Coronavirus(COVID-19)outbreak : what the department of endoscopy should know", Gastrointest Endosc, 92, pp.192~197 (2020)
- Chiu PWY, "Practice of endoscopy during COVID-19 pandemic : position statements of the Asian Pacific Society for Digestive Endoscopy(APSDE-COVID statements)", Gut, 69, pp.991~996 (2020)
- Lui RN, "Overview of guidance for endoscopy during the coronavirus disease 2019 pandemic", J Gastroenterol Hepatol, 35, pp.749~759 (2020)
- "Recommendations for endoscopic procedures during COVID-19outbreak" (2020)[URL]
- The Lancet, "COVID-19 : protecting health-care workers", Lancet, 395, pp.922~ (2020)
- Paterlini M, "On the front lines of coronavirus: the Italian response to covid-19", BMJ, 368, pp.m1065~ (2020)
- 허선, "How to train health personnel to protect themselves from SARS-CoV-2 (novel coronavirus) infection when caring for a patient or suspected case", Journal of Educational Evaluation for Health Professions, 17, pp.1~6 (2020), 한국보건의료인국가시험원
- "Interim infection prevention and control recommendations for patients with suspected or confirmed coronavirus disease 2019 (COVID-19) in healthcare settings" (2020)[URL]
- "CDNA national guidelines for the prevention, control and public health management of COVID-19outbreaks in residential care facilities in Australia" (2020)[URL]
- "Infection prevention and control and preparedness for COVID-19 in healthcare settings – fourth update" (2020)[URL]
- "Coronavirus disease (COVID-19): for health professionals" (2020)[URL]
- "COVID-19 - guidance for health protection teams (HPTs)" (2020)[URL]
- Adams JG, "Supporting the health care workforce during the COVID-19 global epidemic", JAMA, 323, pp.1439~1440 (2020)
- Ong J, "Prevention of nosocomial SARS-CoV-2transmission in endoscopy : international recommendations and the need for a gold standard", Gut, 69, pp.1145~1148 (2020)
- Sociedad Española de Patología Digestiva, "Recommendations by the SEPD and AEG, both in general and on the operation of gastrointestinal endoscopy and gastroenterology units, concerning the current SARS-CoV-2 pandemic (March, 18)", Rev Esp Enferm Dig, 112, pp.319~322 (2020)
- 한지민, "Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak", Clinical Endoscopy, 53(2), pp.243~245 (2020), 대한소화기내시경학회[DOI]