To the Editor:
We read with great interest the article by Repici et al1 regarding the recommendations for the department of endoscopy during the COVID-19 outbreak. Here, we report our experience with >18,000 procedures per year in a tertiary care referral center in Brescia, in northern Italy, which has been at the epicenter of the COVID-19 outbreak in Europe, and a COVID-19 hospital since the beginning of March. During the COVID-19 outbreak, especially during the lockdown, endoscopy unit activities were limited to emergency and oncologic procedures to preserve the health of both patients and operators.
Seven physicians and 19 nurses were dispatched to the COVID-19 department. The remaining 4 physicians and 7 nurses were dedicated to the endoscopy unit. All procedures performed between March 1 and May 1, 2020, were considered high-risk procedures because of the dramatic incidence of infection in that period and in that specific geographic area (Fig. 1 ). Because of this and according to the recommendations by Repici et al, all operators wore high-risk personal protective equipment (including hairnet, 2 pairs of gloves, water-resistant gown, FFP2/3 respirator, face shield) and observed proper hand hygiene during donning and doffing.
Figure 1.
COVID-19 inpatients during SARS-CoV-2 outbreak in Brescia, Italy.
During that time, 375 procedures were performed (166 EGDs, 144 colonoscopies, 21 ERCPs, 23 EUSs, 16 PEGs, 5 video capsule endoscopies) in non–negative-pressure rooms. All patients wore surgical masks (except during upper endoscopy) and gloves. Of those patients, 23 had established COVID-19 positive test results and underwent endoscopic procedures in a dedicated room. All rooms were disinfected and/or decontaminated at the end of each procedure.
No case of transmission of infection in the endoscopy unit was recorded during the observation period and for 15 days after May 1 between operators and patients. After May 15, the hospital organized extensive serologic screening among the staff involved in the endoscopy unit confirming, the absence of infection (IgM and IgG anti–COVID-19: negative). In conclusion, the recommendations Repici et al1 seem to provide a safe and effective method to prevent SARS-CoV-2 diffusion in the department of endoscopy.
Disclosure
All authors disclosed no financial relationships.
Reference
- 1.Repici A., Maselli R., Colombo M. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc. 2020;92:192–197. doi: 10.1016/j.gie.2020.03.019. [DOI] [PMC free article] [PubMed] [Google Scholar]