Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis

Łukasz Dembiński; Urszula Grzybowska-Chlebowczyk; Ewa Toporowska-Kowalska; Jarosław Walkowiak; Beata Gładysiewicz; Maciej Dądalski; Bartosz Korczowski; Elżbieta Czkwianianc; Maciej Zagierski; Elżbieta Jarocka-Cyrta; Anetta Soroczyńska-Wrzyszcz; Tomasz Pytrus; Paulina Krawiec; Aleksandra Banaszkiewicz

doi:10.1016/j.jiph.2023.12.023

Pediatric endoscopy in times of pandemic: A nationwide retrospective analysis

J Infect Public Health. 2024 Mar;17(3):396-400. doi: 10.1016/j.jiph.2023.12.023. Epub 2024 Jan 6.

Authors

Affiliations

¹ Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland. Electronic address: lukaszdembinski@gmail.com.
² Department of Paediatrics, Faculty of Medical Science, Medical University of Silesia, Katowice, Poland.
³ Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Lodz, Poland.
⁴ Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland.
⁵ Department of Gastroenterology and Hepatology, Pediatrics Clinic, Regional Polyclinical Hospital, Kielce, Poland.
⁶ Department of Gastroenterology, Hepatology, Feeding Disorders and Pediatrics, The Children's Memorial Health Institute, Warsaw, Poland.
⁷ Department of Pediatrics and Pediatric Gastroenterology, Institute of Medical Sciences, Medical College, University of Rzeszów, Rzeszów, Poland.
⁸ Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
⁹ Department of Pediatrics, Gastroenterology, Allergology and Nutrition, Medical University of Gdańsk, Gdańsk, Poland.
¹⁰ Department of Clinical Pediatrics, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Provincial Specialist Children's Hospital, Olsztyn, Poland.
¹¹ Regional Hospital in Grudziądz, Grudziądz, Poland.
¹² Department of Pediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, Wroclaw, Poland.
¹³ Department of Pediatrics and Gastroenterology, Medical University of Lublin, Lublin, Poland.
¹⁴ Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland.

PMID: 38246113
DOI: 10.1016/j.jiph.2023.12.023

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.

Keywords: Adverse events; Anesthesia; COVID-19; Children; Colonoscopy; Gastroscopy.

MeSH terms

COVID-19*
Child
Endoscopy, Gastrointestinal / adverse effects
Humans
Pandemics* / prevention & control
Retrospective Studies
SARS-CoV-2