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Dembiński Ł, Grzybowska-Chlebowczyk U, Toporowska-Kowalska E, Walkowiak J, Gładysiewicz B, Dądalski M, Korczowski B, Czkwianianc E, Zagierski M, Jarocka-Cyrta E, Soroczyńska-Wrzyszcz A, Pytrus T, Krawiec P, Banaszkiewicz A. Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis. J Infect Public Health 2024; 17:396-400. [PMID: 38246113 DOI: 10.1016/j.jiph.2023.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/16/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Gastrointestinal endoscopy is a procedure that carries an increased risk of transmission of SARS-CoV-2 infection to medical staff. In patients, COVID-19 is a risk factor for adverse events of medical procedures. This study analyzed the real-life risk of, and factors contributing to, infection transmission to endoscopic personnel, and possible adverse events of the endoscopy procedure and anesthesia in children with COVID-19. METHODS Nationwide retrospective analysis of medical records of children with confirmed SARS-CoV-2 infection who underwent gastrointestinal endoscopy in Poland between February 2020 and February 2022. RESULTS Fifty-eight patients were included in the analysis, 35% of whom had COVID-19 symptoms at the time of endoscopy. The dominant indications for endoscopy were foreign body or corrosive substance ingestion and gastrointestinal bleeding. Nine cases of virus transmission were registered among endoscopic personnel. In all of these cases, the endoscopy team was unaware of the patient's infection (p < 0.01), although symptoms were present in 78% of the children. Lack of use of personal protective equipment was the strongest predictor of SARS-CoV-2 transmission (p < 0.01). The risk of infection was not statistically significantly dependent on the method of anesthesia, intubation or the type of endoscopy. No statistically significant correlation was found between symptomatic infection and adverse events of endoscopy or anesthesia occurrence. There was one reported anesthesia-related adverse event involving extubation difficulties due to worsening respiratory infection symptoms. CONCLUSIONS The risk of transmitting SARS-CoV-2 to endoscopic personnel during procedures in children is low and depends on compliance with infection prevention and control measures. Performing gastrointestinal endoscopy in children with COVID-19 does not appear to be associated with an increased risk of adverse events.
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Affiliation(s)
- Łukasz Dembiński
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.
| | | | - Ewa Toporowska-Kowalska
- Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Beata Gładysiewicz
- Department of Gastroenterology and Hepatology, Pediatrics Clinic, Regional Polyclinical Hospital, Kielce, Poland
| | - Maciej Dądalski
- Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Bartosz Korczowski
- Department of Pediatrics and Pediatric Gastroenterology, Institute of Medical Sciences, Medical College, University of Rzeszów, Rzeszów, Poland
| | - Elżbieta Czkwianianc
- Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Maciej Zagierski
- Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland
| | - Elżbieta Jarocka-Cyrta
- Department of Clinical Pediatrics, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Provincial Specialist Children's Hospital, Olsztyn, Poland
| | | | - Tomasz Pytrus
- Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland
| | - Paulina Krawiec
- Department of Pediatrics and Gastroenterology, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Banaszkiewicz
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
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