Risk Stratification and PPE Use in Pediatric Endoscopy During the COVID-19 Outbreak: A Single-Center Protocol

SARS-CoV-2, the novel coronavirus causing coronavirus disease 2019 (COVID-19), is now a global pandemic. Human-to-human transmission has been documented to occur through respiratory secretions, feces, aerosols, and contaminated environmental surfaces. Pediatric patients present a unique challenge as they may have minimal symptoms and yet transmit disease. Endoscopists face risk for infection with viruses like SARS-CoV-2, as the aerosol generating nature of endoscopy diffuses respiratory disease that can be spread via an airborne and droplet route. We describe our center's methodology for pediatric patient risk stratification to facilitate responsible use of endoscopic resources during this crisis. We also describe our recommendations for use of personal protective equipment by endoscopists, with the goal of ensuring the safety of ourselves, our anesthesiology and endoscopy staff, and our patients. Address correspondence and reprint requests to Daphne S. Say, MD, Assistant Clinical Professor, Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California, Davis, 2516 Stockton Boulevard, Ticon II, Sacramento, CA 95817 (e-mail: dsay@ucdavis.edu). Received 26 March, 2020 Accepted 30 March, 2020 Conflict of Interest Disclosure: The authors have no conflicts of interest relevant to this article to disclose. Funding Source: No funding was secured for this study. Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. © 2020 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology