LAUSR

We read with interest the study by Zhao et al. regarding their experience of performing EUS‐guided fine needle aspiration during COVID‐19 outbreak.[1] We congratulate the authors for sharing their EUS workflow and safety measures put in place to prevent transmission of COVID-19 infection both to the staff and to the patients. Endoscopists access gastrointestinal lumen from close distance to the patient, thereby being exposed to large amount of respiratory, oropharyngeal, and gastrointestinal secretions. Hence, endoscopy is considered a high-risk procedure for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.[2] Moreover, gastrointestinal endoscopy is a procedure that can generate aerosols because of coughing and retching. The risk of transmission may be much higher with therapeutic EUS procedures as these are complex procedures, which require short physical distance between endoscopist and patient for longer period of time, involve presence of increased number of assisting staff in endoscopy suite, involve use of complex endoscopes that are difficult to clean/sterilize, and require exchange of several accessories that may increase risk of spreading potentially infective body fluids.[3]