Prospective analysis of SARS-CoV-2 dissemination to environmental surfaces during endoscopic procedures

Abstract

Background and study aims The COVID-19 pandemic has disrupted routine medical care due to uncertainty regarding the risk of viral spread. One major concern for viral transmission to both patients and providers is performing aerosol-generating procedures such as endoscopy. As such, we performed a prospective study to examine the extent of viral contamination present in the local environment before and after endoscopic procedures on COVID-19 positive patients. Materials and methods A total of 82 samples were collected from 23 surfaces in the procedure area of four COVID-positive patients undergoing upper endoscopic procedures. Samples were collected both before and after the procedure. severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA was extracted and quantified using reverse transcription quantitative polymerase chain reaction with primers to detect nucleocapsid RNA, and results reported as the number of viral copies per square centimeter of contaminated surface. Results A total of six positive samples were detected from three of the four patients. The floor beneath the patient bed was the most common site of viral RNA, but RNA was also detected on the ventilator monitor prior to the procedure and the endoscope after the procedure. Conclusions The risk of SARS-CoV-2 transmission associated with upper endoscopy procedures is low based on the low rate of surface contamination. Some surfaces in close proximity to the patient and endoscopist may pose a higher risk for contamination. Patient positioning and oxygen delivery methods may influence the directionality and extent of viral spread. Our results support the use of appropriate personal protection to minimize risk of viral transmission.

A new system to prevent SARS-CoV-2 and microorganism air transmission through the air circulation system of endoscopes

“…Mechanisms of transmission are still unclear but could be related to air transmission of the virus. Indeed, viable SARS-CoV-2 has been found in hospital air 14 , on a ventilator monitor close to an endoscopic system, on the floor beneath patients’ beds, and in one case in an endoscope 15 . Some medical or surgical procedures increase transmission risk for respiratory pathogens because they directly generate aerosols or during tracheal intubation.…”

COVID-19 und gastrointestinale Endoskopie –angepasste Strategien im pandemischen Wandel

“…Durch Verwendung von optimierter PPE mit KN95-/FFP2-Masken konnte in diesen Zentren eine „nosokomiale“ Transmission von infizierten Patienten auf das Personal verhindert bzw. deutlich eingegrenzt werden [ 4 , 5 , 8 , 19 ]. Der Effekt dieser protektiven Maßnahmen wurde sicherlich durch die während der 2.…”

Airborne transmission of SARS‐Cov2: What consequences for digestive endoscopy?

“… 10 Multivariate analyses of risk factors of SARS‐Cov‐2 transmission identified that patient areas and AGP increase the risk of room contamination, whereas patient masking decreases both air and surface‐borne SARS‐CoV‐2 contamination. 10 In a recent study, SARS‐CoV‐2 was found on the floor beneath the patient bed of the endoscopic room, on the endoscopy cart monitor and on the ventilator, but air contamination was not evaluated. 10 However, air samples containing positive SARS‐CoV‐2 particles have been detected in hospitals since the virus can remain viable in aerosols for over 3 h with an estimated half‐life of 1.1–1.2 h. 11 Nosocomial outbreak resulting from aerosol‐borne SARS‐CoV‐2 introduced by HCW or patients have been shown recently.…”

“… 10 In a recent study, SARS‐CoV‐2 was found on the floor beneath the patient bed of the endoscopic room, on the endoscopy cart monitor and on the ventilator, but air contamination was not evaluated. 10 However, air samples containing positive SARS‐CoV‐2 particles have been detected in hospitals since the virus can remain viable in aerosols for over 3 h with an estimated half‐life of 1.1–1.2 h. 11 Nosocomial outbreak resulting from aerosol‐borne SARS‐CoV‐2 introduced by HCW or patients have been shown recently. These data suggest that air could be a way of transmission of respiratory virus in hospital settings.…”