@article{3031538, title = "COVID-19 in the endoscopy unit: How likely is transmission of infection? Results from an international, multicenter study", author = "Papanikolaou, Ioannis S. and Tziatzios, Georgios and Chatzidakis, and Alexandros and Facciorusso, Antonio and Crino, Stefano Francesco and and Gkolfakis, Paraskevas and Deriban, Gjorgi and Tadic, Mario and Hauser, and Goran and Vezakis, Antonios and Jovanovic, Ivan and Muscatiello, Nicola and and Meneghetti, Anna and Miltiadou, Konstantinos and Stardelova, Kalina and and Lackovic, Alojzije and Bourou, Maria-Zoi and Djuranovic, Srdjan and and Triantafyllou, Konstantinos", journal = "WORLD JOURNAL OF GASTROINTESTINAL ENDOSCOPY", year = "2021", volume = "13", number = "9", pages = "416-425", publisher = "BAISHIDENG PUBLISHING GROUP INC", doi = "10.4253/wjge.v13.i9.416", keywords = "COVID-19; SARS-CoV-2; Gastrointestinal endoscopy; Personal protection measures; Transmission; Lockdown", abstract = "BACKGROUND

Coronavirus disease 2019 (COVID-19) significantly affected endoscopy practice, as gastrointestinal endoscopy is considered a risky procedure for transmission of infection to patients and personnel of endoscopy units (PEU).

AIM

To assess the impact of COVID-19 on endoscopy during the first European lockdown (March-May 2020).

METHODS

Patients undergoing endoscopy in nine endoscopy units across six European countries during the period of the first European lockdown for COVID-19 (March-May 2020) were included. Prior to the endoscopy procedure, participants were stratified as low- or high- risk for potential COVID-19 infection according to the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) joint statement, and contacted 7-14 d later to assess COVID-19 infection status. PEU were questioned regarding COVID-19 symptoms and/or infection via questionnaire, while information regarding hospitalizations, intensive care unit-admissions and COVID-19-related deaths were collected. The number of weekly endoscopies at each center during the lockdown period was also recorded.

RESULTS

A total of 1267 endoscopies were performed in 1222 individuals across nine European endoscopy departments in six countries. Eighty-seven (7%) were excluded because of initial positive testing. Of the 1135 pre-endoscopy low risk or polymerase chain reaction negative for COVID-19, 254 (22.4%) were tested post endoscopy and 8 were eventually found positive, resulting in an infection rate of 0.7% [(95%CI: 0.2-0.12]. The majority (6 of the 8 patients, 75%) had undergone esophagogastroduodenoscopy. Of the 163 PEU, 5 [3%; (95%CI: 0.4-5.7)] tested positive during the study period. A decrease of 68.7% (95%CI: 64.8-72.7) in the number of weekly endoscopies was recorded in all centers after March 2020. All centers implemented appropriate personal protective measures (PPM) from the initial phases of the lockdown.

CONCLUSION

COVID-19 transmission in endoscopy units is highly unlikely in a lockdown setting, provided endoscopies are restricted to emergency cases and PPM are implemented.

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