Management of aerosol generation during upper gastrointestinal endoscopy

Abstract

In the highly contagious coronavirus disease 2019 pandemic, aerosol-generating procedures (AGPs) are associated with high-risk of transmission. Upper gastrointestinal endoscopy is a procedure with the potential to cause dissemination of bodily fluids. At present, there is no consensus that endoscopy is defined as an AGP. This review discusses the current evidence on this topic with additional management. Prevailing publications on coronavirus related to upper gastrointestinal endoscopy and aerosolization from the PubMed and Scopus databases were searched and reviewed. Comparative quantitative analyses showed a significant elevation of particle numbers, implying that aerosols were generated by upper gastrointestinal endoscopy. The associated source events have also been reported. To reduce the dispersion, certain protective measures have been developed. Endoscopic unit protocols are recommended for the concerned personnel. Therefore, upper gastrointestinal endoscopy should be classified as an AGP. Proper practices should be adopted by healthcare workers and patients.

Keywords: Aerosols; COVID-19; Gastroscopy; Health personnel; Respiratory protective devices.

Fig. 1.

Illustration of tools for preventing aerosols from upper gastrointestinal endoscopy. (A) Acrylic box. (B) Acrylic face shield. (C) Plastic sheet. (D) Double surgical mask. (E) B1. (F) P1. (G) Shielding device for endoscopic procedures.