The prevention of nosocomial SARS CoV2 transmission in endoscopy: a systematic review of recommendations within gastroenterology to identify best practice.
Endoscopy generates aerosol droplets and fomites, thereby increasing the risk of SARS CoV2 transmission to healthcare workers and uninfected patients within endoscopy departments. Despite the sharp rise in the incidence of COVID 19, authoritative recommendations to limit the spread of SARS CoV2 within gastrointestinal endoscopy units are lacking. Therefore, with the primary aim of identifying best practice and scrutinizing its supporting evidence, we conducted a systematic review of literature for articles published between 1 January 2002 and 15 March 2020 in five databases relating to both the current SARS CoV2 and the previous SARS CoV outbreaks. Official websites for gastroenterology and endoscopy societies in the 15 most affected countries were also searched. Unfortunately, a paucity of high quality data and heterogeneity of recommendations between countries was observed. Interestingly, not all countries advocated the postponement of non urgent or elective procedures. Recommendations for patient screening and personal protective equipment were commonly featured in all recommendations but specifics varied. Only 32% (9/28) of all gastroenterology and endoscopy societies issued guidance on endoscopy in the COVID 19 pandemic. In conclusion, stronger evidence to inform current practice and robust guidelines are urgently needed to prevent the transmission of SARS CoV2 in gastrointestinal endoscopy departments worldwide.
medRxiv