• Clinics · Jan 2020

    Approach to Endoscopic Procedures: A Routine Protocol from a Quaternary University Referral Center Exclusively for Coronavirus Disease 2019 Patients.

    • Tomazo Antonio Prince Franzini, Ana Paula Samy Tanaka Kotinda, Diogo Turiani Hourneaux de Moura, Márcia Lopes Vicente Badana, Marion Sielfeld de Medeiros, Patrícia Goulart Rodrigues Lima, Brigitte Feiner de Mello, Rafael Priante Kayano, CarmonaMaria José CarvalhoMJCDivisao de Anestesiologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR., Marcelo Cristiano Rocha, Aléia Faustina Campos, Thomas R McCarty, Thaís Guimarães, Maria Luisa do Nascimento Moura, Christopher C Thompson, and MouraEduardo Guimarães Hourneaux deEGH0000-0002-8023-3722Unidade de Endoscopia Gastrointestinal, Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR..
    • Unidade de Endoscopia Gastrointestinal, Departamento de Gastroenterologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
    • Clinics (Sao Paulo). 2020 Jan 1; 75: e1989.

    ObjectivesThe present coronavirus disease (COVID-19) pandemic has ushered in an unprecedented era of quality control that has necessitated advanced safety precautions and the need to ensure the adequate protection of healthcare professionals (HCPs). Endoscopy units, endoscopists, and other HCP may be at a significant risk for transmission of the virus. Given the immense burden on the healthcare system and surge in the number of patients with COVID-19, well-designed protocols and recommendations are needed. We aimed to systematically characterize our approach to endoscopic procedures in a quaternary university hospital setting and provide summary protocol recommendations.MethodThis descriptive study details a COVID-19-specific protocol designed to minimize infection risks to patients and healthcare workers in the endoscopy unit.ResultsOur institution, located in São Paulo, Brazil, includes a 900-bed hospital, with a 200-bed-specific intensive care unit exclusively designed for patients with moderate and severe COVID-19. We highlighted recommendations for infection prevention and control during endoscopic procedures, including appropriate triage and screening, outpatient management and procedural recommendations, role and usage of personal protective equipment (PPE), and role and procedural logistics involving COVID-19-positive patients. We also detailed hospital protocols for reprocessing endoscopes and cleaning rooms and also provided recommendations to minimize severe acute respiratory syndrome coronavirus 2 transmission.ConclusionThis COVID-19-specific administrative and clinical protocol can be replicated or adapted in multiple institutions and endoscopy units worldwide. Furthermore, the recommendations and summary protocol may improve patient and HCP safety in these trying times.

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