Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2020; 26(36): 5387-5394
Published online Sep 28, 2020. doi: 10.3748/wjg.v26.i36.5387
COVID-19 pandemic and challenges in pediatric gastroenterology practice
Jamal Kriem, Riad Rahhal
Jamal Kriem, Department of Pediatrics, Central Michigan University/Covenant Medical Center, Saginaw, MI 48602, United States
Riad Rahhal, Division of Pediatric Gastroenterology, University of Iowa Children’s Hospital, Iowa, IA 52242, United States
Author contributions: Kriem J contributed to the study conception and design, drafted the initial article and approved the final article; Rahhal R contributed to the study conception and design, performed data abstraction, provided critical revision of the manuscript and approved the final article.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jamal Kriem, MD, Assistant Professor, Department of Pediatrics, Central Michigan University/Covenant Medical Center, 1447 N Harrison St, Saginaw, MI 48602, United States. jkriem@gmail.com
Received: May 7, 2020
Peer-review started: May 7, 2020
First decision: May 15, 2020
Revised: June 28, 2020
Accepted: September 11, 2020
Article in press: September 11, 2020
Published online: September 28, 2020

The current coronavirus pandemic is imposing unpreceded challenges to the practice of pediatric gastroenterology. These are highlighted in their impact on performing aerosol-generating endoscopy procedures and the need to accommodate longer room turnaround time for disinfection, ensuring appropriate and consistent safety measures for patients, staff and providers, and emphasizing the importance for screening patients for active coronavirus disease (COVID) infection before endoscopy when possible. Pediatric patients are less likely to exhibit severe COVID-related symptoms so survey-based screening would not be a sensitive measure to identify patients with active infections. To address the restrictions of patients coming for face to face clinic encounters, there has been rapid expansion of telehealth services in a very short time period with several difficulties encountered. To survive these challenges, pediatric gastroenterology practices need to adapt and accept flexibility in clinical operations with ongoing commitment to safety for patients and healthcare workers.

Keywords: Coronavirus, Pandemic, Pediatric, Gastroenterology, Endoscopy, Screening, Telehealth

Core Tip: This article highlights the impact of the current coronavirus pandemic on the field of pediatric gastroenterology. We present the available data on infection incidence, symptomatology and screening in children. We focus on the difficulties noted in offering endoscopy services and the accommodations needed to achieve that while maintaining safety for patients and providers. We also describe our experience with the rapid expansion of telehealth services in light of restrictions in face to face clinic visits and the challenges associated with that.