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Aerosol generation and droplet spread during nasogastric intubation in the COVID-19 era
  1. Wout Verbeure1,
  2. Annelies Geeraerts1,
  3. I-Hsuan Huang1,2,
  4. Lien Timmermans3,
  5. Joran Toth1,
  6. Hannelore Geysen1,
  7. Louise Cools1,
  8. Florencia Carbone1,3,
  9. Jolien Schol1,
  10. Herman Devriese4,
  11. Rico Haesaerts3,
  12. Hideki Mori1,
  13. Tim Vanuytsel1,3,
  14. Jan Tack1,3
  1. 1 Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (ChroMeta), KU Leuven, Leuven, Belgium
  2. 2 Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan
  3. 3 Gastroenterology and Hepatology, KU Leuven University Hospitals, Leuven, Belgium
  4. 4 Prevention and Environment, KU Leuven University Hospitals, Leuven, Belgium
  1. Correspondence to Professor Jan Tack, Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases Metabolism and Ageing (ChroMetA), KU Leuven, Leuven 3000, Belgium; jan.tack{at}med.kuleuven.be

https://doi.org/10.1136/gutjnl-2020-323836

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    We read with interest the recent article by Repici et al who reported that gastrointestinal (GI) endoscopy seems relatively safe for medical staff wearing adequate protective measures, with 4.3% of 968 healthcare workers (HCW) in the endoscopy setting infected with COVID-19.1 Similar to GI endoscopy, oesophageal motility studies are common practice and potentially also high-risk medical procedures as COVID-19 may spread through generation of aerosols and droplets during insertion and removal of oesophageal high resolution manometry (HRM) and 24 hours multichannel intraluminal impedance-pH monitoring (pH-MII) probes.2 Current guidelines recommend high-level protection with N95 mask, Filtering FacePiece (FFP)2 or FFP3, double gloves, face shield and gown for HCW during oesophageal physiologic procedures to minimise the risk of transmission.3 4 However, there is a lack of scientific evidence on the spread of aerosols and droplets during nasogastric intubation. Therefore, we performed a prospective study, addressing these concerns.

    Patients with a negative COVID-19 test by PCR undergoing nasogastric intubation for HRM or pH-MII were included. During the procedures, patients wore a mask over the mouth and were seated in a lowered position in front of …

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    Footnotes

    • Contributors JT designed the study. WV and AG planed and conducted the study. I-HH drafted the manuscript. All authors participated in the data collection and revised and approved the final manuscript.

    • Funding JT is supported by a Methusalem grant of KU Leuven and has given Scientific advice to AlfaWassermann, Allergan, Christian Hansen, Danone, Grünenthal, Ironwood, Janssen, Kiowa Kirin, Menarini, Mylan, Neutec, Novartis, Noventure, Nutricia, Shionogi, Shire, Takeda, Theravance, Tramedico, Truvion, Tsumura, Zealand and Zeria pharmaceuticals and has served on the Speaker bureau for Abbott, Allergan, AstraZeneca, Janssen, Kyowa Kirin, Menarini, Mylan, Novartis, Shire, Takeda, Truvion and ZeriaJolien Schol is a PhD fellow fundamental research of the Flanders Research Foundation (FWO Vlaanderen).

    • Competing interests TV is a senior clinical investigator of the Flanders Research Foundation (FWO Vlaanderen) and has given Scientific Advice to Takeda, VectivBio, Shire, Dr. Falk Pharma, Tramedico, Truvion and Zealand Pharma and has served on the Speaker bureau for Abbott, Kyowa Kirin, Menarini, Takeda, Tramedico and Truvion.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

    • Provenance and peer review Not commissioned; internally peer reviewed.