Abstract
BackgroundCoronavirus disease 2019 (COVID-19) has become a global pandemic, with healthcare workers at a high risk of exposure. During this pandemic, endoscopists must wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission; however, few studies have reported the impact of face shields on the quality of gastrointestinal (GI) endoscopy. We aimed to determine whether the use of PPE, including face shields, affected the quality of GI endoscopy during the COVID-19 pandemic.MethodsThe medical records of patients who had undergone screening or surveillance colonoscopy and gastric endoscopic submucosal dissection (ESD) at Dong-A University Hospital between June 2020 and March 2021 were retrospectively reviewed. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists also wore face shields. We compared GI endoscopy quality indicators between the first five months (no face shields) and the second five months (with face shields). In the non-face shield and face shield groups, we calculated the overall adenoma detection rates (ADRs), polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), complete resection rate (CRR), number of polyps and/or adenomas per colonoscopy, and gastric ESD procedure time.ResultsIn total, 1359 study patients had undergone screening or surveillance colonoscopy (face shield group, n = 679; non-face shield group, n = 680). No statistically significant between-group differences were observed (PDR, 49.04 vs. 52.50%, p = 0.202; ADR, 38.59 vs. 38.97%, p = 0.884; SSPDR, 1.91 vs. 1.32%, p = 0.388; ANDR, 3.98 vs. 3.97%, p = 0.991, respectively). No difference was found in colonoscopy quality indicators between patients examined by experienced and trainee endoscopists with and without face shields. Of 144 study patients who had undergone gastric ESD for gastric neoplasms, there were 72 patients in each group. No statistically significant differences were found in the CRR (94.44 vs 93.05%, p = 1.000) and procedure times (19.22 ± 9.33 vs. 19.03 ± 11.49, p = 0.911).ConclusionsWearing face shields during the COVID-19 pandemic did not affect the quality indicators for GI endoscopy.
Highlights
Coronavirus disease 2019 (COVID-19) has become a global pandemic, with healthcare workers at a high risk of exposure
Colonoscopy quality indicators between the groups In total, 1359 patients were included in this study; 680 and 679 procedures were performed without and with face shields, respectively
There were no significant differences between the two groups regarding patients’ age and sex, bowel preparation, sedation, use of antiplatelet or anticoagulation, time of examination, indication for examination, type of colonoscope, and endoscopist’s experience (Table 1)
Summary
Coronavirus disease 2019 (COVID-19) has become a global pandemic, with healthcare workers at a high risk of exposure During this pandemic, endoscopists must wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission; few studies have reported the impact of face shields on the quality of gastrointestinal (GI) endoscopy. The World Endoscopy Organization, the American Society for Gastrointestinal Endoscopy, the American Gastroenterological Association, the European Society of Gastrointestinal Endoscopy, and the Asian Pacific Society for Digestive Endoscopy have made several recommendations for clinicians to follow during the COVID-19 pandemic that include assessing the risk of COVID-19 to determine when to perform an endoscopy and recommending that all endoscopists wear appropriate personal protective equipment (PPE) to prevent COVID-19 transmission [6,7,8,9,10]. Many protective devices had previously been used during endoscopy, but face shields had not been used prior to the COVID19 pandemic
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