ABSTRACT
Background and aim: Italy was the first European country to face the outbreak of COVID-19. The aim of this study was to show its impact on the activity of a tertiary care Endoscopy Unit with more than 18,000 procedures/year. Materials and methods: This is a single-center study performed at Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. Our Institution was converted to COVID-19 Hospital from January to April 2020 and only emergency and oncologic procedures were maintained to preserve both patients’ and operators’ health. Data about outpatients visits and endoscopic examinations performed from January to April 2020 were compared to those of the same period of the previous year. Results: A dramatic drop of all activities was shown. All outpatient visits decreased of 45,89% (1100 vs 2033), including -39.5% (227 vs 375) of Inflammatory Bowel Disease and -28.6% (30 vs 42) of biliopancreatic visits. All endoscopic examinations diminished of 74.1% (562 vs 2173). In detail, colonoscopies were reduced of 78.8% (266 vs 1256), including -85.5% (29 vs 200) of screening procedures, EGDS of 70.4% (241 vs 814), EUS of 44.8% (32 vs 58) and ERCP of 48.9% (23 vs 45). Overall, -64.6% of Gastro-Intestinal (GI) cancers were detected (17 vs 48). A reduction of 77.8% and 80% were obtained in terms of advanced adenomas (i.e., high grade dysplasia and villous histology) and adenocarcinomas detected during colonoscopy (22 vs 100 and 6 vs 30, respectively). These absolute reductions were not compensated by significative increase of relative diagnostic yields which were 3.3% vs 2.3% (17/507 vs 48/2070;Odd Ratio [OR] 0.94), 8.3% vs 7.9% (22/266 vs 100/1256;OR 1.05) and 2.3% vs 2.4% (6/266 vs 30/1256;OR 0.94) for all GI cancers, advanced adenomas, and colorectal cancer in 2020 and 2019, respectively. Although a reduction of 35.3%, a significant improvement was showed comparing diagnostic yield of gastric adenocarcinoma in 2020 and 2019, being 4.6% vs 2.1% (11/241 vs 17/814;OR 0.44), respectively. Conclusions: The COVID-19 outbreak caused a notably decrease of all activities, including colorectal screening colonoscopy. This produced a reduction of the total amount of neoplasia detected compared to the same period of the previous year. The consequences of this delay are still to be shown.
ABSTRACT
Aims Italy was the first European country to experience COVID-19 outbreak. The aim of this study was to show its impacton the activity of a tertiary care Endoscopy Unit with >18,000 procedures/year. Methods This is a single-center study performed at Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy. OurInstitution was converted to COVID-19 Hospital from January to April 2020 and only emergency and oncologic procedureswere maintained to preserve both patients' and operators' health. Data about outpatients visits and endoscopicexaminations performed from January to April 2020 were compared to the same period of 2019. Results A dramatic drop of all activities was shown. In details, overall outpatient visits decreased of-45,89 % (1100 vs2033), including-39.5 % (227 vs 375) of IBD and-28.6 % (30 vs 42) biliopancreatic visits. Endoscopic examinations alsodiminished considerably as shown in table 1. Overall,-64.6 % of gastro-intestinal cancers were detected (17 vs 48). Areduction of-77.8 % and-80 % were obtained in terms of advanced neoplasia (i.e. high-grade dysplasia and villoushistology) and adenocarcinomas detected during colonoscopy between the two years (22 vs 100 and 6 vs 30, respectively).Such absolute reduction was not compensated by an increase of relative diagnostic yield, being 8.3 % vs 7.9 % (22/266 vs100/1256;Odd Ratio [OR] 1.05) and 2.3 % vs 2.4 % (6/266 vs 30/1256;OR 0.94) for advanced neoplasia and colorectalcancer, respectively. Although a reduction of-35.3 %, a significant improvement was showed comparing diagnostic yield ofgastric adenocarcinomas, being 2.1 % vs 4.6 % (17/814 vs 11/241;OR 0.44), respectively. Conclusions COVID-19 caused a notably decrease of all activities, including screening colonoscopy. This produced areduction of the total amount of neoplasia detected during endoscopy compared to the same period of the previous year.The consequences of this delay are still to be shown. (Table Presented).