IFSO Endoscopy Committee Position Statement on the Practice of Bariatric Endoscopy During the COVID-19 Pandemic
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ORIGINAL CONTRIBUTIONS
IFSO Endoscopy Committee Position Statement on the Practice of Bariatric Endoscopy During the COVID-19 Pandemic Christine Stier 1 & Gontrand Lopez-Nava 2 & Manoel Galvao Neto 3 & Christopher C. Thompson 4 & Josemberg Campos 5 & Mousa Khoursheed 6 & Muffazal Lakdawala 7 & Almino Ramos 8 & Barham K. Abu Dayyeh 9
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract COVID-19 (Coronavirus disease 2019) caused by SARS-CoV-2 has become a global pandemic. Obesity is a risk factor for severe disease, and the practice of endoscopy poses special challenges and risks of SARS-CoV-2 transmission to patients and providers given the evolving role of the gastrointestinal tract in viral transmission and aerosol generation during endoscopic procedures. It is therefore necessary to distinguish between urgent interventions that cannot be postponed despite the risks during the pandemic and, in contrast, purely elective interventions that could be deferred in order to minimize transmission risks during a time of infection surge and limited access. Semi-urgent bariatric procedures have an intermediate position. Since the chronological course of the pandemic is still unpredictable, these interventions were defined according to whether or not they should be performed within a nominal 8-week period. In this position statement, the IFSO Endoscopy Committee offers guidance on navigating bariatric endoscopic procedures in patients with obesity during the COVID-19 pandemic, in the hope of mitigating the risk of SARS-CoV-2 transmission to vulnerable patients and healthcare workers. These recommendations may evolve as the pandemic progresses. Keywords Endoscopy . Bariatric . COVID-19 . Obesity . Obesity surgery . Bariatric endoscopy
Position Statement * Barham K. Abu Dayyeh [email protected] 1
Sana Hospitals Germany, Obesity Center North Rhine-Westphalia, Department of General-, Visceral-, and Transplant Surgery, RWTH Aachen University, Aachen, Germany
2
Bariatric Endoscopy Unit at HM Sanchinarro University Hospital in Madrid, Madrid, Spain
3
FMABC, Santo Andre, Sao Paulo, Brazil
4
Division of Gastroenterology, Brigham and Women’s Hospital, Boston, MA, USA
5
Federal University of Pernambuco, Recife, Brazil
6
Department of Surgery, Kuwait University, Kuwait City, Kuwait
7
Institute of Minimal Access Surgical Sciences and Research Centre, Saifee Hospital, Mumbai, India
8
Gastro-Obeso-Center Institute, Sao Paulo, Brazil
9
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
COVID-19 (Coronavirus disease 2019) caused by SARSCoV-2 has become a global pandemic. The World Health Organization (WHO) declared COVID-19 as a pandemic on 11 March 2020. Up until 23 April, 2,649,680 cases have been reported in 185 countries [https://coronavirus.jhu.edu/map. html]. Studies showed that typical clinical symptoms included cough, sore throat, fever, fatigue, and shortness of breath [1]. So far, pulmonary manifestations, including interstitial pneumonia, which in its
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