ABSTRACT
More than 2 years have passed since the outbreak of coronavirus disease 2019 (COVID-19), but there is still no sign that the COVID-19 pandemic has ended. Although vaccines have shown high efficacy against severe acute respiratory syndrome coronavirus 2, a risk of adverse reactions and thrombosis has also been reported. Here we review the current knowledge regarding vaccination in patients with neuroimmunological diseases and those receiving immunosuppressive drugs or disease-modifying therapy.
Subject(s)
COVID-19 Vaccines , COVID-19 , Pandemics , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , Immunosuppressive Agents/adverse effects , Pandemics/prevention & control , SARS-CoV-2ABSTRACT
AIM: To elucidate the impact of the coronavirus disease 2019 (COVID-19) on the practice of high-resolution manometry (HRM) and peroral endoscopic myotomy (POEM) in Japan. METHODS: We utilized a large-scale database involving 14 high-volume centers in Japan to investigate changes in the numbers of HRM and POEM procedures performed and outcomes of POEM between 2019 and 2020. A questionnaire survey was also conducted to analyze pandemic-associated changes in the HRM and POEM protocols. RESULTS: Compared to that in 2019, the number of HRM and POEM procedures decreased by 17.2% (1587-1314) and 20.9% (630-498), respectively. These declines were prominent during the state of emergency from April to May 2020, particularly in pandemic areas. HRM and POEM in nonpandemic areas were relatively unaffected. From 2019 to 2020, there was a 0.4% (254-248) decrease in POEM cases within the prefecture, but the number outside the prefecture decreased by 33.6% (372-247). During the pandemic, the safety and efficacy of POEM were maintained. The implementation of personal protective equipment (PPE) measures varied among facilities, and PPE for POEM was relatively insufficient compared to that for HRM. CONCLUSION: The COVID-19 pandemic influenced HRM and POEM practices in Japan. It is necessary to establish a sufficient system for HRM and POEM in each hospital as well as countrywide to overcome the effects of the pandemic.
Subject(s)
COVID-19 , Esophageal Achalasia , Esophageal Motility Disorders , Myotomy , Natural Orifice Endoscopic Surgery , COVID-19/epidemiology , Esophageal Achalasia/surgery , Esophageal Motility Disorders/surgery , Esophageal Sphincter, Lower , Esophagoscopy/methods , Humans , Japan/epidemiology , Manometry/methods , Myotomy/methods , Natural Orifice Endoscopic Surgery/methods , Pandemics/prevention & control , Treatment OutcomeABSTRACT
INTRODUCTION: During the coronavirus disease 2019 pandemic, whether endoscopy generates aerosols needs to be determined. METHODS: In patients undergoing upper gastrointestinal endoscopy with an enclosure covering their heads, 0.3-10-µm aerosols were measured for 60 seconds before, during, and after endoscopy by an optical counter. Whether aerosols increased in the situation with and without endoscopy was examined. RESULTS: The analysis included 103 consecutive patients undergoing endoscopy and 90 control patients. Aerosols increased significantly during endoscopy compared with the control group. Body mass index and burping were significant factors related to increased aerosols during endoscopy. DISCUSSION: Upper gastrointestinal endoscopy was an aerosol-generating procedure.