ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic

Abstract

We are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy (www.esge.com) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (www.esgena.org) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.

Conflict of interest statement

I. M. Gralnek has received lecture fees from Astra-Zeneca, Taro Pharma, Vifor Pharma and 3D Matrix (ongoing); consultant fees from Boston Scientific, GI view, Motus GI and Symbionix (ongoing); and is DSMB Member by Intec Pharma, MAB member by Motus GI. J. E. van Hooft has received lecture fees from Medtronics (2014 – 2015) and Cook Medical (2019), and consultancy fees from Boston Scientific (2014 – 2017); her department has received research grants from Cook Medical (2014 – 2019) and Abbott (2014 – 2017). M. Kaminski has received lecture fees from Boston Scientific (2018 – ongoing) and consultancy fees from Olympus and Fujifilm (2018-ongoing). P. D. Siersema has received research grants from Norgine, Pentax, Microtech, Yakult and Motus GI (ongoing) and is on the Advisory Board of Motus GI. G. Antonelli, C. Hassan, A. Ebigbo, M. Pellisé, M. Arvanitakis, P. Bhandari, R. Bisschops, K. Triantafyllou, G. Webster, H. Pohl, T. Ponchon, H. Messmann, M. Dinis-Ribeiro have no competing interest.

© Georg Thieme Verlag KG Stuttgart · New York.

Figures

Fig. 1

Decision pathway for GI endoscopic procedures during the COVID-19 pandemic. GI, gastrointestinal; PPE, personal protective equipment.

Fig. 2

List of indications for endoscopic procedures according to rescheduling recommendations and priority.