Abstract
Esophagogastroduodenoscopy (EGD) has a high risk of virus transmission during the current coronavirus disease 2019 era, and preventive measures are under investigation. We investigated the effectiveness of a newly developed patient-covering negative-pressure box system (Endo barrier®) (EB) for EGD. Eighty consecutive unsedated patients who underwent screening EGD with EB use were prospectively enrolled. To examine the aerosol ratio before, during, and after EGD, 0.3- and 0.5-μm aerosols were measured every 60 s using an optical counter. Moreover, the degree of contamination of the examiners’ goggles and vinyl gowns was assessed before and after EGD using a rapid adenosine triphosphate (ATP) test for simulated droplets. Data were available in 73 patients and showed that 0.3- and 0.5-μm particles did not increase in 95.8% (70/73) and 94.5% (69/73) of patients during EGD under EB. There were no significant differences in the total 0.3- or 0.5-μm particle counts before versus after EGD. The difference in the ATP levels before and after EGD was −0.6 ± 16.6 relative light units (RLU) on goggles and 1.59 ± 19.9 RLU on gowns (both within the cutoff value). EB use during EGD may provide a certain preventive effect against aerosols and droplets, decreasing examiners’ exposure to viruses.
Highlights
The COVID-19 pandemic has had an extraordinary impact on the delivery of gastrointestinal endoscopy, with an initial reduction to 12% of the prepandemic level in the United
Esophagogastroduodenoscopy (EGD) is an aerosol-generating procedure that has the potential to transmit the virus from infected patients to health care workers (HCWs); among all HCWs in the field of gastroenterology, the risk of COVID-19 is reportedly highest among endoscopy technicians [2]
Transnasal endoscopy was performed in 60% (48/80) of patients, and oral endoscopy was performed in 40% (32/80)
Summary
This reduction in activity has the serious effect of delaying the diagnosis of important diseases such as early gastrointestinal malignancies [1]. Esophagogastroduodenoscopy (EGD) is an aerosol-generating procedure that has the potential to transmit the virus from infected patients to health care workers (HCWs); among all HCWs in the field of gastroenterology, the risk of COVID-19 is reportedly highest among endoscopy technicians [2]. Several guidelines, including those of the World Endoscopy Organization, the European Society of Gastrointestinal Endoscopy, the Asian Pacific Society of Digestive
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