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<article article-type="brief-report" dtd-version="1.0" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">CE</journal-id>
<journal-title-group>
<journal-title>Clinical Endoscopy</journal-title><abbrev-journal-title>Clin Endosc</abbrev-journal-title></journal-title-group>
<issn pub-type="ppub">2234-2400</issn>
<issn pub-type="epub">2234-2443</issn>
<publisher>
<publisher-name>Korean Society of Gastrointestinal Endoscopy</publisher-name></publisher></journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.5946/ce.2020.123</article-id>
<article-id pub-id-type="publisher-id">ce-2020-123</article-id>
<article-categories>
<subj-group>
<subject>Brief Report</subject></subj-group></article-categories>
<title-group>
<article-title>Use of a Glove-Covered Mouthpiece during Upper Endoscopy to Prevent COVID-19 Transmission</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0003-4043-5562</contrib-id>
<name><surname>Sasaki</surname><given-names>Sho</given-names></name>
<xref ref-type="corresp" rid="c1-ce-2020-123"/>
<xref ref-type="aff" rid="af1-ce-2020-123"><sup>1</sup></xref>
</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-6695-9754</contrib-id>
<name><surname>Nishikawa</surname><given-names>Jun</given-names></name>
<xref ref-type="aff" rid="af2-ce-2020-123"><sup>2</sup></xref>
</contrib>
<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid">http://orcid.org/0000-0002-8365-7547</contrib-id>
<name><surname>Sakaida</surname><given-names>Isao</given-names></name>
<xref ref-type="aff" rid="af3-ce-2020-123"><sup>3</sup></xref>
</contrib>
<aff id="af1-ce-2020-123">
<label>1</label>Department of Gastroenterology, Saiseikai Yamaguchi Hospital, Yamaguchi, <country>Japan</country></aff><aff id="af2-ce-2020-123">
<label>2</label>Department of Laboratory Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, <country>Japan</country></aff><aff id="af3-ce-2020-123">
<label>3</label>Department of Gastroenterology and Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi, <country>Japan</country></aff></contrib-group>
<author-notes>
<corresp id="c1-ce-2020-123">Correspondence: Sho Sasaki Department of Gastroenterology, Saiseikai Yamaguchi Hospital, Midorimachi 2-11, Yamaguchi 753-8517, Japan Tel: +81-083-901-6111, Fax: +81-083-921-0714, E-mail: <email>yudaon@yahoo.co.jp</email></corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>3</month>
<year>2021</year></pub-date>
<pub-date pub-type="epub">
<day>21</day>
<month>8</month>
<year>2020</year></pub-date>
<volume>54</volume>
<issue>2</issue>
<fpage>289</fpage>
<lpage>290</lpage>
<history>
<date date-type="received">
<day>5</day>
<month>5</month>
<year>2020</year></date>
<date date-type="rev-recd">
<day>3</day>
<month>6</month>
<year>2020</year></date>
<date date-type="accepted">
<day>3</day>
<month>6</month>
<year>2020</year></date>
</history>
<permissions>
<copyright-statement>Copyright &#x000A9; 2021 Korean Society of Gastrointestinal Endoscopy</copyright-statement>
<copyright-year>2021</copyright-year>
<license>
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions>
</article-meta></front>
<body>
<p>Coronavirus disease of 2019 (COVID-19) caused by SARS-CoV-2 has become a global pandemic. All endoscopic procedures should be postponed until the spread of infection has subsided &#x0005b;<xref ref-type="bibr" rid="b1-ce-2020-123">1</xref>&#x0005d;. However, endoscopy may be necessary to diagnose and treat gastrointestinal cancers and bleeding. Aerosol dispersion due to coughing and retching during upper endoscopic procedures are considered an infection risk. Personal protective equipment (PPE) including face shield, N95 respirator (or surgical mask), cap, isolation gown and disposable gloves is recommended for the medical staffs, whereas patients should be masked until just before endoscopy &#x0005b;<xref ref-type="bibr" rid="b2-ce-2020-123">2</xref>,<xref ref-type="bibr" rid="b3-ce-2020-123">3</xref>&#x0005d;.</p>
<p>We have devised a mouthpiece to prevent aerosol dispersion during endoscopy. This involved cutting the finger off a disposable nitrile glove, followed by cutting the tip of the finger off and then attaching the finger to the mouthpiece for use as the insertion port of the endoscope (<xref rid="f1-ce-2020-123" ref-type="fig">Fig. 1A</xref>, <xref rid="f1-ce-2020-123" ref-type="fig">B</xref>). This method was initially applied for overtubes to prevent air leak during endoscopic submucosal dissection. Endoscopic procedure remained feasible, and any aerosolized particles would be trapped by the rubber seal (<xref rid="f1-ce-2020-123" ref-type="fig">Fig. 1C</xref>). No patients complained of breathlessness or experienced decreased oxygen saturation.</p>
<p>This &#x0201c;glove-covered mouthpiece&#x0201d; may be effective in combination with PPE to prevent transmission of SARS-CoV-2 infection by aerosolization during upper endoscopy.</p>
</body>
<back>
<fn-group>
<fn fn-type="conflict"><p><bold>Conflicts of Interest:</bold> The authors have no potential conflicts of interest.</p></fn>
<fn fn-type="financial-disclosure"><p><bold>Funding</bold></p>
<p> None.</p></fn>
<fn fn-type="participating-researchers">
<p><bold>Author Contributions</bold></p>
<p>Supervision: Isao Sakaida</p>
<p>Writing-original draft: Sho Sasaki</p>
<p>Writing-review&amp;editing: Jun Nishikawa</p>
</fn>
</fn-group>
<ref-list>
<title>REFERENCES</title>
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<sec sec-type="display-objects">
<title>Figure</title>
<fig id="f1-ce-2020-123" position="float">
<label>Fig. 1.</label><caption><p>Glove-covered mouthpiece. (A) The finger of a disposable nitrile glove was first cut off. (B) The tip of the finger was then cut off and the finger was attached to the mouthpiece for use as the insertion port of the endoscope. (C) Any aerosolized particles would be trapped by the rubber seal.</p></caption>
<graphic xlink:href="ce-2020-123f1.tif"/>
</fig>
</sec>
</back></article>