ABSTRACT
Over 16 million cases worldwide, severe acute respiratory syndrome coronavirus 2 has profoundly affected healthcare as we know it. Given reports of gastrointestinal involvement and viral shedding in the stool, it is unsurprising there are concerns that endoscopic equipment may be a potential vector of viral transmission. Here, we provide an overview of existing practices for endoscope reprocessing, recent developments in the field, and challenges in the COVID-19 environment. Current multi-society guidelines do not advise any change to endoscope disinfection protocols but emphasize strict adherence to recommended practices. However, endoscopy reprocessing staff may benefit from supplemental personal protective equipment measures, especially in high risk situations. Because thorough endoscope reprocessing is highly operator dependent, adequate training of personnel is critical for proper manual cleaning and disinfection of endoscopes that have potential to harbor virus. Bacterial contamination of duodenoscopes has caused outbreaks of infection from multidrug-resistant organisms, highlighting vulnerable areas. The emphasis of current studies is on optimization of disinfection and drying, minimization of simethicone use, and on quality control of endoscope reprocessing with sampling and microbiological culturing. Recent advances include novel approaches to endoscope sterilization, infection barrier methods, and design of partially or fully disposable duodenoscopes. Overall, the available data indicate that, when correctly executed, current reprocessing practices are sufficient in preventing SARS-COV-2 transmission.
ABSTRACT
Early case reports and surveys suggest that transmission risk during endoscopy is low given proper personal protective equipment (PPE) usage. [...]data is needed to shape practice-changing guidelines regarding booster vaccine mandates and pre-procedural screening in high-risk fields such as endoscopy. Results Demographics Number of responses 72 Age (mean ± SD) 47.4 ± 11.6 Gender Male 23 (31.9%) Female 49 (68.1%) COVID-19 Positivity Tested Positive for COVID-19 Yes 9 (12.5%) No 63 (87.5%) Timing of COVID-19 Positivity Before vaccination 9 (100.0%) After vaccination 0 (0.0%) January 2020 to June 2020 2 (22.2%) July 2020 to December 2020 5 (55.6%) January 2021 to June 2021 1 (11.1%) June 2021 to December 2021 1 (11.1%) Symptom Severity in Positive Individuals Asymptomatic 0 (0.0%) Mild 5 (55.6%) Moderate 4 (44.4%) Severe 0 (0.0%) Critical illness 0 (0.0%) Endoscopy Center Guidelines Endoscopy Center Mask Requirements Does not require N95 for any patient 14 (19.4%) Only for suspected COVID-19 patients 32 (44.4%) For all upper endoscopic procedures 5 (6.9%) For all endoscopic procedures 20 (27.8%) Other 1 (1.4%) Mandatory Pre-Procedural Testing Yes 43 (59.7%) No 29 (40.3%) Endoscopy Provider Perceptions Perception of safety performing endoscopic procedures after receiving vaccination compared to before Much safer 41 (56.9%) Somewhat safer 20 (27.8%) Same 9 (12.5%) Somewhat less safe 1 (1.4%) Much less safe 0 (0.0%) No response 1 (1.4%)