Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Philip Wai Yan Chiu¹, Siew C Ng², Haruhiro Inoue³, D Nageshwar Reddy⁴, Enqiang Ling Hu⁵, Joo Young Cho⁶, Lawrence Ky Ho⁷, David G Hewett^{8

9}, Han-Mo Chiu¹⁰, Rungsun Rerknimitr¹¹, Hsiu-Po Wang¹², Shiaw Hooi Ho¹³, Dong Wan Seo¹⁴, Khean-Lee Goh¹⁵, Hisao Tajiri^{16

17}, Seigo Kitano¹⁸, Francis K L Chan¹⁹

Affiliations

¹ Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
² Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong siewchienng@cuhk.edu.hk.
³ Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
⁴ Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India.
⁵ Department of Gastroenterology and Hepatology, General Hospital of Chinese PLA, Beijing, China.
⁶ Digestive Endoscopy Center, CHA Bundang Medical Center, CHA University, Seoul, Republic of Korea.
⁷ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁸ School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹¹ Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
¹² Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
¹³ Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁴ Asan Medical Center, Songpa-gu, Seoul, Republic of Korea.
¹⁵ Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
¹⁶ Division of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan.
¹⁷ Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
¹⁸ Oita University, Oita, Japan.
¹⁹ Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.

PMID: 32241897
PMCID: PMC7211066
DOI: 10.1136/gutjnl-2020-321185

Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Philip Wai Yan Chiu et al. Gut. 2020 Jun.

. 2020 Jun;69(6):991-996.

doi: 10.1136/gutjnl-2020-321185. Epub 2020 Apr 2.

Authors

Affiliations

¹ Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
² Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong siewchienng@cuhk.edu.hk.
³ Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan.
⁴ Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India.
⁵ Department of Gastroenterology and Hepatology, General Hospital of Chinese PLA, Beijing, China.
⁶ Digestive Endoscopy Center, CHA Bundang Medical Center, CHA University, Seoul, Republic of Korea.
⁷ Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
⁸ School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁹ Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia.
¹⁰ Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹¹ Department of Medicine, Chulalongkorn University, Bangkok, Thailand.
¹² Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
¹³ Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
¹⁴ Asan Medical Center, Songpa-gu, Seoul, Republic of Korea.
¹⁵ Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia.
¹⁶ Division of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan.
¹⁷ Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
¹⁸ Oita University, Oita, Japan.
¹⁹ Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.

PMID: 32241897
PMCID: PMC7211066
DOI: 10.1136/gutjnl-2020-321185

Abstract

Coronavirus-19 (COVID-19) caused by SARS-CoV-2 has become a global pandemic. Risk of transmission may occur during endoscopy and the goal is to prevent infection among healthcare professionals while providing essential services to patients. Asia was the first continent to have a COVID-19 outbreak, and this position statement of the Asian Pacific Society for Digestive Endoscopy shares our successful experience in maintaining safe and high-quality endoscopy practice at a time when resources are limited. Sixteen experts from key societies of digestive endoscopy in Asia were invited to develop position statements, including patient triage and risk assessment before endoscopy, resource prioritisation and allocation, regular monitoring of personal protective equipment, infection control measures, protective device training and implementation of a strategy for stepwise resumption of endoscopy services after control of the COVID-19 outbreak.

Keywords: clinical decision making; endoscopy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: SK is president of the Asian Pacific Society of Digestive Endoscopy (APSDE); HT is vice president of APSDE; PWYC, H-PW, RR, SHH are serving as councillors of APSDE.

Figures

**Figure 1**
Flow chart to prescreen and triage patients for endoscopy during COVID-19 outbreak. PPE, personal protective equipment.

**Figure 2**
Recommended PPE for general patient triage and handling suspected COVID-19 cases. AAMI, Association for the Advancement of Medical Instrumentation; PPE, personal protective equipment. Image courtesy of the Hospital Authority of Hong Kong.

See this image and copyright information in PMC

Comment in

APSDE-COVID statements: recommendations should be modified according to the prevalence of COVID infection rates.
Bhandari P, Alkandari A. Bhandari P, et al. Gut. 2020 Jul;69(7):1367-1368. doi: 10.1136/gutjnl-2020-321360. Epub 2020 Apr 30. Gut. 2020. PMID: 32354989 No abstract available.
Elective endotracheal intubation for urgent gastrointestinal endoscopy among hospitalized patients with SARS-CoV-2.
Wander P, Hogan DE, Inamdar S, Benias PC, Haddad F, Andrawes S, Bernstein DE, Sejpal DV, Trindade AJ; Northwell COVID-19 Research Consortium. Wander P, et al. Gastrointest Endosc. 2020 Oct;92(4):992-995. doi: 10.1016/j.gie.2020.06.039. Epub 2020 Jun 18. Gastrointest Endosc. 2020. PMID: 32565189 Free PMC article. No abstract available.

References

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1. WHO Coronavirus disease (COVID-2019) situation reports. Situation report – 64, 2020. Available: https://www.who.int/docs/default-source/coronaviruse/situation-reports/2...
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Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Affiliations

Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements)

Authors

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Abstract

Conflict of interest statement

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