Preliminary information on prevention of infections caused by SARS-COV-2 virus in endoscopic laboratories
Jolanta Gruszecka 1, 2  
More details
Hide details
Medical College of the University Institute of Health Sciences, Rzeszów, Poland
Department of Clinical Microbiology, Clinical Hospital No. 2 im. Św. Jadwigi Królowej, Rzeszów, Poland
Faculty of Medicine, University of Rzeszów, Poland
Department of Gastroenterology with IBD Unit of Clinical Hospital No. 2 im. Św. Jadwigi Królowej, Rzeszów, Poland
Jolanta Gruszecka   

Medical College of Rzeszow University Institute of Health Sciences, ul. Warzywna 1a, 35-310, Rzeszów, Poland
On 11 March 2020, the Director-General of the World Health Organization (WHO) announced COVID-19 (Coronavirus Disease 2019) as a global pandemic Currently, no vaccines are available and there is little evidence of the efficacy of potential therapeutic agents. Furthermore, there is presumably no pre-existing immunity in the population to the new coronavirus, and it is as-sumed that everyone in the population is susceptible.

The aim of the procedures described in the article is to minimize the risk of human-to-human transmission of the SARS-CoV-2 (Severe acute respiratory syndrome – coronavirus 2) virus during procedures carried out in endoscopic laboratories.

Brief description of the state of the art:
SARS-CoV-2 infection can be asymptomatic, cause severe pneumonia, or lead to death. Symptoms of COVID-19 range from none (asymptomatic) to severe pneumonia and it can be fatal. Case studies to-date indicate that this infection causes a mild illness (i.e. pneumonia or mild pneumonia) in approximately 80% of cases, and most cases recove; 14% have a more severe illness, 6% experience a critical illness. The vast majority of the most serious illnesses and deaths have occurred among the elderly and people with other chronic underlying diseases. Average progression times include: • in mild cases: from the onset of symptoms to recovery in almost 2 weeks; • in severe cases: from the onset of symptoms to recovery in 3–6 weeks, and from symptoms to death in 2–8 weeks.

Special precautions should be taken and procedures followed when performing invasive medical procedures in endoscopic laboratories in patients with specific or clinically probable SARS-CoV-2 infection. This article contains up-to-date information as at 04/04/2020.

Polish Ministry of Health, (access: 2020-04-04).
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 [Epub ahead of print].
Holshue ML, DeBolt C, Lindquist S, et al. First Case of 2019 Novel Coronavirus in the United States. 2020 [Epub ahead of print].
JOINT GI SOCIETY MESSAGE: COVID-19 Clinical Insights for Our Community of Gastro-enterologists and Gastroenterology Care Providers. Available from: (access: 2020-02-04).
European Centre for Disease Prevention and Control. Novel coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK – sixth update – 12 March 2020. Stockholm: ECDC; 2020. Available from:
Wróblewska M. Koronawirusy. In: Heczko PB, Wróblewska M, Pietrzyk A, [eds.] Medical mi-crobiology. Warsaw: PZWL (National Institute of Medical Publications); 2014. pp. 337–340.
Pyrć K. The human coronaviruses. Postępy Nauk Medycznych [Advances in Medical Sciences], 2015; 28(4B): 48–54.
Chan J, Yuan S, Kok K, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020; 395(10223): 514–523. DOI: 10.1016/S0140-6736(20)30154-9 (access: 2020-03-11).
Zhang Y, Zhang X, Liu Y, et al. Suggestions of Infection Prevention and Control in Digestive Endoscopy During Current 2019-nCoV Pneumonia Outbreak in Wuhan, Hubei Province, China. Endoscopy 2020; 52: 312–314. DOI: 10.1055/a-1128-4313.
Zhu Na, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020. DOI: 10.1056/NEJMoa2001017.
11. (access: 2020-02-14).
12. (access: 23.03.2020).
Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020 Mar 17. doi:10.1056/NEJMc2004973.
European Centre for Disease Prevention and Control. Interim guidance for environmental cleaning in nonhealthcare facilities exposed to SARS-CoV-2. ECDC: Stockholm; 2020. Available from: (access: 2020-03-02).
COVID-19: BSG and BASL advice for healthcare professionals in Gastroenterology and Hepa-tology. Available from: (access: 2020-04-01).
European Centre for Disease Prevention and Control. Infection prevention and control for COVID-19 in healthcare settings– Third update. 31 March 2020. ECDC: Stockholm; 2020. Availa-ble from: healthcare-settings.
ASGE Quality Assurance in Endoscopy Committee. ASGE guideline for infection control dur-ing GI endoscopy. Gastrointest Endosc 2018; 87: 1167–1179.
Bayot ML, Limaiem F. Biosafety Guidelines. StatPearls. Treasure Island (FL): StatPearls Pub-lishing; 2020 February 20.
Center for Disease Control and Prevention (CDC). Sequences for donning and doffing of PPE. Available from: (access: 2020-03-21).
Recommended Personal Protective Equipment (PPE) in hospitals/clinics under Serious/ Emergency Response Level Coronavirus disease (COVID-19). Available from: (access: 2020-03-22).
Klompas M. Coronavirus Disease 2019 (COVID-19): Protecting Hospitals From the Invisible. Ann Intern Med. [Epub Ahead of print 11 March 2020]. Available from:
European Centre for Disease Prevention and Control. Guidance for wearing and removing personal protective equipment in healthcare settings for the care of patients with suspected or confirmed COVID-19. Stockholm: ECDC; 2020. Available from:
Sultan S et al. AGA Institute rapid recommendations for gastrointestinal procedures during the COVID-19 pandemic. Gastroenterology 2020 Apr 1; [e-pub]. (
Repici A, Maselli R, Colombo M, et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. GI Endoscopy 2020 [Epub ahead of print]. Available from: impact-of-covid-19-on-endoscopy.pd (access: 2020-03-30).
Chopra V, Toner E, Waldhorn R, et al. How Should U.S. Hospitals Prepare for Coronavirus Disease 2019 (COVID-19)? Ann Intern Med. 2020; [Epub ahead of print 11 March 2020]. Available from:
Beilenhoff U, Biering H, Blum R, Brljak J, Cimbro M, Dumonceau JM, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018. Endoscopy 2018; 50(12): 1205–1234.
Center for Disease Control and Prevention (CDC). Disinfection of Healthcare Equipment. Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008. Update: May 2019. Accessible version: (access: 2020-02-25).
Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses. 2012; 4(11): 3044–68.
Cao Z, Zhang Q, Lu X, et al. Estimating the effective reproduction number of the 2019-nCoV in China. 29, 2020.
Regulation of the Minister of Health of October 5, 2017 on the detailed method of dealing with medical waste (Journal of Laws of 2017, item 1975).