ABSTRACT
The sensitive and specific detection of an infection with SARS-CoV-2 is the basis of all infection control management. Since the beginning of the pandemic, the discussion has primarily focused on the availability of diagnostic options, then on correct material collection and effective handling of the scarce test resource, and finally on the value of individual procedures and the use of rapid test methods. The following overview attempts to summarize in a compact form the current state of knowledge on the rational and effective working with laboratory diagnostics of SARS-CoV-2 infections using predominantly scientific review articles.
ABSTRACT
BACKGROUND: In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions. METHODS: Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021. RESULTS: Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021. CONCLUSION: A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.
Subject(s)
COVID-19 Testing/statistics & numerical data , COVID-19/diagnosis , Endoscopy, Gastrointestinal/statistics & numerical data , Preoperative Care/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Germany , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Young AdultABSTRACT
The SARS-CoV-2 pandemic is a challenging task in pediatric cancer hospitals. During intensive chemotherapy, children and adolescents, close contacts, caregivers, and the healthcare team in this highly specialized clinical care units must be protected against SARS-CoV-2 transmission and disease. This article addresses the management of the SARS-CoV-2 pandemic in a German pediatric cancer center. © mhp Verlag GmbH, Wiesbaden, 2021. Alle Rechte vorbehalten. Nur zur privaten Nutzung.