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Update on mechanisms of transmission of severe acute respiratory syndrome Coronavirus (SARS-COV-2) in endoscopy

Gastroenterology & Hepatology: Open Access
Cortés AY,1 Jiménez L Miguel A,2  Valenzuela J,3 Jaramillo BC,4 Ruíz MF,5 López Itzikowitz, David, Rodríguez Esau,6 Pedroza S7

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Purpose: To update the mechanisms of transmission of infection of severe acute respiratory syndrome coronavirus (SARS-COV-2) during endoscopy, virus is transmitted via multiple routes the spread of infections such as SARS-COV-2 in endoscopic procedures occurs in asymptomatic patients or for emergency procedures. All endoscopies should be considered aerosol-generating procedures in the outbreak. The virus is transmitted through direct contact with multi-organ secretions days before and after respiratory distress syndrome by people, droplets, aerosols, endoscopes shows potential risk to infection to staff and patients. Knowledge of the mechanisms and diagnosis will allow reduce of transmission during endoscopic procedures and implement strict follow-up of recommendations for SARS-COV-2 prevention. The principal pathophysiologic mechanism to infect tissues is the expression of angiotensin-converting enzyme II receptor (ACE-2) the characteristic of the virus to enter the human cell is expressed in the lungs, gastrointestinal (ileum, colon, liver), ocular, blood, stool, bone marrow (73.3% vs.14.3%, p.0.033) vs. patients with respiratory symptoms so transmission can be done through a high or low endoscopic procedure. 
Aim: To review an update on mechanisms of transmission another than respiratory. 
Methods: Based on recent literature review we summarize from available published of different mechanisms of transmission and pathogenicity of SARS-COV-2 that putting in risk of transmission during endoscopy procedures. Criteria used were PubMed for articles describing gastrointestinal endoscopy-associated infections by aerosols, fomites and outbreaks published from 2019 to 2020. 
Results: Aerosols and fomites are important for transmission; the viral tropism and life cycle are their principal mechanism with the receptor ACE-2 in tissues. 
Conclusions: Results of this review show that virus can be transmitted through direct contact 
with secretions and fomites days before and after respiratory distress syndrome with infection in multiple organs in patients with SARS-COV-2.


transmission, mechanisms, endoscopy, aerosols, SARS-COV-2, ACE-2, respiratory distress syndrome, bone marrow, ileum, colon, liver, kidney, skin, ocular, corona-viridae, cycle threshold