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在意大利中部,在 SARS-CoV-2 感染大流行期间可以安全地进行胃肠内窥镜检查。

Gastrointestinal endoscopy can be safely performed during pandemic SARS-CoV-2 infection in Central Italy.

机构信息

Department of Surgical-Medical Sciences and Translational Medicine, Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University of Rome.

General Management, Sant'Andrea Hospital.

出版信息

Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e505-e512. doi: 10.1097/MEG.0000000000002155.

DOI:10.1097/MEG.0000000000002155
PMID:33795580
Abstract

OBJECTIVES

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly contagious; gastrointestinal endoscopies are considered risky procedures for the endoscopy staff. Data on the SARS-CoV-2-exposure/infection rate of gastrointestinal endoscopy staff is scarce. This study aimed to assess the SARS-CoV-2-exposure/infection rate among gastrointestinal endoscopists/nurses performing gastrointestinal endoscopies before and after the adoption of specific prevention measures.

PATIENTS AND METHODS

Cross-sectional study in a teaching hospital (Rome, Central Italy) on retrospective data (9 March-15 April 2020) of consecutive gastrointestinal endoscopies, characteristics of procedures, patients and endoscopy staff, SARS-CoV-2-exposure/positivity of patients and staff before and after adoption of prevention measures. Exposed staff tested for SARS-CoV-2 by nasopharyngeal swabs(RNA-PCR) and serology.

RESULTS

A total of 130 gastrointestinal endoscopies were performed in 130 patients (age 66 ± 14 years, 51% women, 51% inpatients, 56.9% lower). A total of 12 (9.2%) patients were SARS-CoV-2-positive and 14(10.8%) had a high risk of potential infection. Of the endoscopy staff (n = 16, 5 endoscopists, 8 nurses and 3 residents), 14 (87.5%) were exposed to SARS-CoV-2-infected and 16 (100%) to potentially infected patients. 3/5 and 5/5 endoscopists were exposed to actual and potential, 1/3 and 3/3 residents to actual and potential and 8/8 nurses to actual and potential infection, respectively. None of the staff was found to be infected with SARS-CoV-2. None experienced fever or any other suspicious symptoms of coronavirus disease 2019. Before the adoption of prevention measures, more endoscopists/nurses were in the endoscopy room than after (3.5 ± 0.6 vs. 2.1 ± 0.3, P < 0.0001).

CONCLUSIONS

Despite supposed high infection risk, gastrointestinal endoscopies may be safe for the endoscopy staff during the SARS-CoV-2 pandemic.

摘要

目的

严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)具有高度传染性;胃肠内镜检查被认为是对内镜医护人员有风险的操作。关于 SARS-CoV-2 暴露/感染率的胃肠内镜医护人员的数据很少。本研究旨在评估在采用特定预防措施前后,进行胃肠内镜检查的胃肠内镜医师/护士的 SARS-CoV-2 暴露/感染率。

患者和方法

这是一家教学医院(意大利罗马中部)的横断面研究,回顾性分析了 2020 年 3 月 9 日至 4 月 15 日期间连续进行的胃肠内镜检查、操作特点、患者和内镜医护人员、采用预防措施前后患者和医护人员的 SARS-CoV-2 暴露/阳性率。暴露的医护人员通过鼻咽拭子(RNA-PCR)和血清学检测进行 SARS-CoV-2 检测。

结果

共对 130 名患者(年龄 66±14 岁,51%为女性,51%为住院患者,56.9%为下消化道)进行了 130 例胃肠内镜检查。共有 12 例(9.2%)患者 SARS-CoV-2 阳性,14 例(10.8%)有潜在感染的高风险。在 16 名内镜医护人员(5 名内镜医师、8 名护士和 3 名住院医师)中,14 名(87.5%)接触过 SARS-CoV-2 感染患者,16 名(100%)接触过有潜在感染风险的患者。3/5 名内镜医师和 5/5 名住院医师接触过实际和潜在感染患者,1/3 名住院医师和 3/3 名住院医师接触过实际和潜在感染患者,8/8 名护士接触过实际和潜在感染患者。没有医护人员被发现感染 SARS-CoV-2。没有人出现发热或任何其他可疑的 2019 年冠状病毒病症状。在采用预防措施之前,进入内镜室的内镜医师/护士人数多于之后(3.5±0.6 与 2.1±0.3,P<0.0001)。

结论

尽管感染风险较高,但在 SARS-CoV-2 大流行期间,胃肠内镜检查对内镜医护人员可能是安全的。

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