Procedimientos endoscópicos y pandemia COVID19. Consideraciones básicas

El SARS-Cov-2 es un coronavirus productor de la enfermedad COVID-19 Esta inicio en Wuhan, capital de la provincia Hubei, China En menos de cuatro meses la enfermedad se disperso por el mundo, lo que dio origen a miles de muertes La Organizacion Mundial de la Salud (OMS) la ha declarado pandemia La humanidad esta consternada, multiples gobiernos han obligado al aislamiento total, con exito variable debido a la negligencia de parte de la comunidad En muchas ciudades las instituciones y el personal sanitario no son suficientes para atender la catastrofe El aislamiento es la unica estrategia eficaz para detener el crecimiento logaritmico de COVID-19 El motivo cientifico del aislamiento es que mas del 60 % de los contagios surgen de personas asintomaticas La enfermedad no solo produce sintomas respiratorios El SARS-Cov-2, ademas, puede producir nauseas, dolor abdominal, vomito, diarrea, anosmia y ageusia El 50% de los infectados pueden tener sintomas digestivos, que incluso preceden a los respiratorios La ruta fecal-oral trasmite el virus, aun sin diarrea En las unidades de endoscopia estan todas las formas de contagio: aerosoles (vomitos, arcadas, eructos, flatos), materia fecal, contacto estrecho, contaminacion del ambiente Se deben suspender todas las endoscopias programadas para diagnostico Solo deben realizarse las urgentes y terapeuticas Todo el personal de endoscopia debe tener medidas de proteccion estrictas El paciente debe saber que en la sala de endoscopia puede contagiarse, con constancia en el consentimiento informado Debe contactarse al paciente posendoscopia via telefonica a los dias 7 y 14 para indagar sobre todos los sintomas mencionados (AU) SARS-CoV-2 is the coronavirus which produces the dreaded COVID-19 Starting in Wuhan, the capital of China's Hubei province, it has spread it spread throughout the world in less than four months and has caused thousands of deaths The WHO has declared it to be a pandemic Humanity is shocked, and many governments have imposed total isolation It has had varying success due to community negligence In many cities, institutions and health personnel have not successfully managed this catastrophe Isolation is the only effective strategy to stop the logarithmic growth of COVID 19 The scientific reason for isolation is that more than 60 % of infections arise from asymptomatic people SARS-CoV-2 not only produces respiratory symptoms but can also cause nausea, abdominal pain, vomiting, diarrhea, anosmia and ageusia Fifty percent of those infected may have digestive symptoms which may even precede respiratory symptoms The fecal-oral route can transmit the virus even when there is no diarrhea All forms of contagion are found in endoscopy units: aerosols from vomiting, retching, bel-ching, and flatus;fecal matter, close contact, and contamination of the environment All diagnostic endoscopies should be discontinued Only urgent and therapeutic endoscopy should be performed All endoscopy personnel must have strict protection measures Each patient should be informed, and sign an informed consent form, that the virus can be spread within the endoscopy room After performance of endoscopy, the patient should be contacted by phone on days 7 and 14 to inquire about all symptoms mentioned (AU)