Endoscopy during COVID-19 Pandemic

Abstract

The ongoing pandemic of coronavirus disease 2019 (COVID-19) poses a major global health threat. The infected patients may present with a broad spectrum of clinical signs and symptoms, from being asymptomatic to developing flu-like symptoms or pneumonia, acute respiratory distress syndrome, multi-organ failure, and death .^1,2 Gastrointestinal symptoms are also common in patients with COVID-19, and some cases may first present with nausea, vomiting, and diarrhea even without other symptoms.^3,4 Although viral transmission is primarily through small respiratory droplets and direct contact, there is also the possibility of both bioaerosol transmission and fecal contamination.⁴ Furthermore, there is evidence of viral shedding in asymptomatic subjects or during the long incubation period of the virus.⁵ That is why all healthcare providers, staff, and even patients of the endoscopy department are at great risk of COVID-19 infection, and therefore, special precautions for disease prevention should be taken to ensure their safety.

Gastroenterologists are at higher risk for COVID-19 by respiratory and fecal-oral routes. Among 480 gastroenterologists, 10.6% had confirmed COVID-19 in Iran .⁶

With this background, the “Guideline on Endoscopy during COVID-19 Pandemic” in Iran was compiled and edited based on the consensus of a group of gastroenterologists on the latest knowledge and international guidelines, as well as the survey of colleagues’ opinions and experiences in this context. Here, we outline a summary of these recommendations in five distinct categories. The full text was published before in the Persian languag.