COVID-19 and endoscopy services in intermediately affected countries: a position statement from the saudi gastroenterology association

Involvement of the digestive system in COVID-19. A review

“…The following were reviewed: from the United States, the guidelines of the American Gastroenterological Association (AGA), 46 the American College of Gastroenterology(ACG) and the American Society for Gastrointestinal Endoscopy (ASGE); 47 from Europe, the guidelines of the European Society Gastrointestinal Endoscopy Nurses and Associates (ESGENA); 48 from Spain, the guidelines of the Sociedad Española de Patología Digestiva (SEPD)-Asociación Española de Gastroenterología (AEG) [Spanish Association of Gastrointestinal Disease (SEPD)-Spanish Association of Gastroenterology (AEG)]; 45 from the Asia-Pacific region, the guidelines of the Asian Pacific Society of Digestive Endoscopy (APSDE); 49 from the United Kingdom, the guidelines of the British Society of Gastroenterology (BSG); 50 from Japan, the guidelines of the Japan Gastroenterological Endoscopy Society (JGES); 51 from Saudi Arabia, the guidelines of the Saudi Gastroenterology Association (SGA); 52 and from India, the guidelines of the Society of Gastrointestinal Endoscopy of India, the Indian Society of Gastroenterology and Indian National Association for the Study of the Liver (SGEI-ISG-INASL). 53 …”

“…All organisations 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 recommend prioritising emergency examinations: upper and lower gastrointestinal bleeding with haemodynamic repercussions, endoscopic retrograde cholangiopancreatography in cases of obstructive acute cholangitis, acute dysphagia, obstruction requiring stent placement and gastrostomy placement when feeding cannot be delayed.…”

“…Regarding assessment of patients’ risk of infectiousness , all the sources consulted 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 recommend screening with a clinical interview 24 h before and on the day of the test. Fever, cough, dyspnoea and gastrointestinal symptoms (diarrhoea) in the past 2 weeks with no apparent cause, as well as patients’ potential contact with patients with confirmed COVID-19, are to be investigated.…”

“…Most organisations 45 , 49 , 50 , 51 , 52 , 53 , 54 , 56 , 57 , 58 have no low level of risk of infectiousness, and refer only to intermediate risk (no symptoms) and high risk (symptoms, contact or confirmed COVID-19 diagnosis). Only patients who had and recovered from the infection and had a negative PCR would be low risk.…”

“…All the guidelines 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 agree on applying general measures (hand-washing before and after each examination, observance of social distancing, and use of surgical face masks outside of rooms), training stable working teams, avoiding the transfer of endoscopists to potentially infected areas, using one computer per physician and cleaning work stations daily with a specific disinfectant solution.…”