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COVID-19 大流行对德国“热点”地区一家内镜中心多学科团队的影响:单中心经验

Impact of the COVID-19 pandemic on an interdisciplinary endoscopy unit in a German "hotspot" area: a single center experience.

机构信息

Department of General, Visceral and Transplantation Surgery, Interdisciplinary Endoscopy Unit, University Hospital Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.

Department of Internal Medicine VIII, Pneumology, University Hospital Tübingen, Ottfried-Müller-Strasse 14, 72076, Tübingen, Germany.

出版信息

Surg Endosc. 2021 Nov;35(11):6212-6219. doi: 10.1007/s00464-020-08119-w. Epub 2020 Nov 2.


DOI:10.1007/s00464-020-08119-w
PMID:33140149
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7605334/
Abstract

BACKGROUND AND STUDY AIMS: Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19), has posed a pandemic threat to global health and has challenged health care system in all affected countries. PATIENTS AND METHODS: This is a combined study including a descriptive part about the changes in the daily work routine of an Interdisciplinary Endoscopic Unit (IEU) and a prospective analysis of patients tested positive for SARS-CoV-2 who required endoscopic interventions. Conclusively, we present the finding of a point-prevalence analysis in the staff of the IEU. RESULTS: We present effects of the COVID-19-related restructuring of processes in our interdisciplinary endoscopy unit (IEU) with respect to cancelation of examinations, relocation of staff to other departments, impact of SARS-CoV-2 on medical staff of the IEU, and supply of protective clothing. Additionally, we analyzed the cohort of COVID-19 patients: Sixteen endoscopic interventions were done in ten patients. In all patients with confirmed infection with SARS-CoV-2, emergency endoscopies were required for relevant bleeding situations. Re-endoscopies were required only in critically ill COVID-19 patients. CONCLUSIONS: The restructuring of processes in the IEU was feasible in short time, effective, and can also be applied broadly at least in developed countries [Garbe et al. in Gastroenterology 159:778-780, 2020; Repici A, Pace F, Gabbiadini R, Colombo M, Hassan C, Dinelli M, Group IG-CW, Maselli R, Spadaccini M, Mutignani M, Gabbrielli A, Signorelli C, Spada C, Leoni P, Fabbri C, Segato S, Gaffuri N, Mangiavillano B, Radaelli F, Salerno R, Bargiggia S, Maroni L, Benedetti A, Occhipinti P, De Grazia F, Ferraris L, Cengia G, Greco S, Alvisi C, Scarcelli A, De Luca L, Cereatti F, Testoni PA, Mingotto R, Aragona G, Manes G, Beretta P, Amvrosiadis G, Cennamo V, Lella F, Missale G, Lagoussis P, Triossi O, Giovanardi M, De Roberto G, Cantu P, Buscarini E, Anderloni A, Carrara S, Fugazza A, Galtieri PA, Pellegatta G, Antonelli G, Rosch T, Sharma P (2020) Endoscopy units and the COVID-19 Outbreak: a Multi-Center Experience from Italy. Gastroenterology;]. The endoscopy-related rate of SARS-CoV-2 infection of staff is low, but supply of protective equipment is crucial for this. Endoscopic procedures in COVID-19 patients were not directly related to SARS-CoV-2 infection, but to other underlying diseases or typical complications of long-term ICU treatment.

摘要

背景与研究目的:自 2019 年 12 月以来,导致 2019 年冠状病毒病(COVID-19)的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)对全球健康构成了大流行威胁,并挑战了所有受影响国家的医疗保健系统。

患者和方法:这是一项联合研究,包括描述性部分,介绍了跨学科内镜科(IEU)日常工作流程的变化,以及对需要内镜介入的 SARS-CoV-2 检测呈阳性的患者进行的前瞻性分析。最后,我们在 IEU 工作人员中进行了一项时点患病率分析。

结果:我们展示了 COVID-19 相关流程重组对我们跨学科内镜科(IEU)的影响,包括检查取消、工作人员调往其他部门、SARS-CoV-2 对 IEU 医务人员的影响以及防护装备的供应。此外,我们分析了 COVID-19 患者队列:十名患者进行了十六次内镜介入。所有确诊感染 SARS-CoV-2 的患者均因相关出血情况需要紧急内镜检查。仅在危重症 COVID-19 患者中需要再次内镜检查。

结论:IEU 中的流程重组在短时间内是可行的、有效的,并且至少在发达国家也可以广泛应用[Garbe 等人在 Gastroenterology 159:778-780,2020 年;Repici A、Pace F、Gabbriadi R、Colombo M、Hassan C、Dinelli M、IG-CW 小组、Maselli R、Spadaccini M、Mutignani M、Gabbrielli A、Signorelli C、Spada C、Leoni P、Fabbri C、Segato S、Gaffuri N、Mangiavillano B、Radaelli F、Salerno R、Bargiggia S、Maroni L、Benedetti A、Occhipinti P、De Grazia F、Ferraris L、Cengia G、Greco S、Alvisi C、Scarcelli A、De Luca L、Cereatti F、Testoni PA、Mingotto R、Aragona G、Manes G、Beretta P、Amvrosiadis G、Cennamo V、Lella F、Missale G、Lagoussis P、Triossi O、Giovanardi M、De Roberto G、Cantu P、Buscarini E、Anderloni A、Carrara S、Fugazza A、Galtieri PA、Pellegatta G、Antonelli G、Rosch T、Sharma P(2020 年)内镜科和 COVID-19 爆发:意大利多中心经验。胃肠病学;]。工作人员中与 SARS-CoV-2 感染相关的内镜率较低,但防护设备的供应对此至关重要。COVID-19 患者的内镜检查与 SARS-CoV-2 感染本身无直接关系,而是与其他潜在疾病或长期 ICU 治疗的典型并发症有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/36fd3db9a998/464_2020_8119_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/1cdf54d6dce9/464_2020_8119_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/edfea8dd08dc/464_2020_8119_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/36fd3db9a998/464_2020_8119_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/1cdf54d6dce9/464_2020_8119_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/edfea8dd08dc/464_2020_8119_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ecfa/8523422/36fd3db9a998/464_2020_8119_Fig3_HTML.jpg

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引用本文的文献

[1]
Setting up a three-stage pre-endoscopy triage during the coronavirus disease 2019 pandemic: A multicenter observational study.

DEN Open. 2022-8-8

[2]
[Influence of the COVID-19 pandemic on robotic visceral surgery in Germany].

Chirurgie (Heidelb). 2022-8

[3]
Analysis of the effects of the first and second/third waves of the COVID-19 pandemic on an Interdisciplinary Endoscopy Unit in a German 'hotspot' area: a single-center experience.

Therap Adv Gastroenterol. 2022-3-23

[4]
Systematic review and meta-analysis of clinical outcomes of COVID-19 patients undergoing gastrointestinal endoscopy.

Therap Adv Gastroenterol. 2021-8-30

[5]
What gastroenterologists should know about SARS-CoV 2 vaccine: World Endoscopy Organization perspective.

United European Gastroenterol J. 2021-9

本文引用的文献

[1]
German Endoscopy Unit Preparations for the Coronavirus Disease 2019 Pandemic: A Nationwide Survey.

Gastroenterology. 2020-8

[2]
Performing Bronchoscopy in Times of the COVID-19 Pandemic: Practice Statement from an International Expert Panel.

Respiration. 2020-4-28

[3]
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Gut. 2020-11

[4]
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Endoscopy. 2020-4-17

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Pneumologie. 2020-5

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Gastroenterology. 2020-7

[7]
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Arab J Gastroenterol. 2020-3

[8]
Hemorrhagic Problem Among the Patients With COVID-19: Clinical Summary of 41 Thai Infected Patients.

Clin Appl Thromb Hemost. 2020

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Int J Infect Dis. 2020-3-28

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N Engl J Med. 2020-2-28

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