The use of aerosol generating procedures (AGPs) during the COVID-19 pandemic in the diagnosis of lung cancer: a narrative review.

OBJECTIVE

In this article we discuss the current evidence for these concerns and highlight where further work is required to understand the risk from these procedures and how it can be mitigated for.

BACKGROUND

The COVID-19 (coronavirus-19 or SARS-CoV-2) pandemic has impacted on many aspects of patient care both for those with the virus and those with other illnesses. Of particular concern has been the risk to staff and patients from the spread of the virus in health care settings. This has led to changes in guidelines and practice in community and hospital settings that has implications on patient diagnostic pathways in lung cancer, with a specific emphasis on aerosol generating procedures (AGPs).

METHODS

A literature search was carried out and 44 abstracts were initially found. Given the novel status of COVID-19, we included severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) in our search. Five papers were selected for further analysis. An additional paper was highlighted during our research and therefore included in our review.

CONCLUSIONS

The papers selected assessed the risk of transmission during AGPs. The six articles selected assessed the risk of aerosol transmission during various AGPs (bronchoscopy, pleural procedures and pulmonary function tests) and each found that the risk of viral transmission via aerosol was low. As mentioned above, at the time the paper was written, there was a paucity of evidence regarding AGPs in the era of COVID-19. There is emerging evidence that our understanding of these procedures may be outdated and the risk of transmission maybe lower than previously anticipated. However, we need further reliable evidence to change practice going forward.

Informations de copyright

2021 Mediastinum. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at: https://dx.doi.org/10.21037/med-21-16). The series “Changes in management of mediastinal tumours following the surge of COVID-19 pandemic” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.