ABSTRACT
Introduction: COVID-19 significantly affected endoscopic practice, as gastrointestinal endoscopy is considered a risky procedure for transmission of infection to patients and personnel of endoscopy units (PEU). This multicenter study aimed to assess the impact of COVID-19 on endoscopy during the first European lockdown (March-May 2020). Aims & Methods: Patients undergoing endoscopy during the period of the first European lockdown for COVID-19 (March-May 2020) were included. Those deemed as low risk or negative for COVID-19 via polymerase chain reaction (PCR) testing were contacted 7-14 days later to assess infection status. Information for possible COVID-19 infection of PEU and number of weekly endoscopies in each center during the lockdown period were also recorded. Results: One thousand two hundred sixty-seven endoscopies were performed in 1222 individuals, across 9 European centers (6 countries). Among the 1135 pre-endoscopically low risk or PCR negative for COP0911 VID-19, 254 (22.4%) were tested post-endoscopy and 8 were eventually found positive, resulting in an infection rate of 0.7% (95%CI: 0.2-0.12). The majority (6 patients, i.e., 75%) turned positive after esophagogastroduodenoscopy (EGD). Of these, 4 (50%) were considered obviously irrelevant to endoscopy, but for the other 50% the route of transmission remained obscure. Data regarding 163 PEU was recorded;5 [3%;95%CI: 0.4-5.7) tested positive during the study period. In 4 of them (2% of the total), the infection was considered to be associated to their work environment. A decrease of 68.7% (95%CI: 64.8-72.7) in the number of weekly endoscopies was recorded in all centers after March 2020. All centers implemented appropriate personal protective measures (PPM) from the initial phases of the lockdown. Conclusion: COVID-19 transmission in endoscopic units is highly unlikely in a lockdown setting, provided endoscopies are reduced to emergency cases and PPM are implemented.
ABSTRACT
Aims COVID-19 has significantly affected endoscopic practice, as GI-endoscopy is considered a risky procedure fortransmission of infection towards personnel of endoscopy units (PEU) and patients. ESGE recommended reduction of non-emergency endoscopies, personal protection measures (PPM) and post-endoscopy calls to patients, to check their COVID-19 status. This study aimed to assess the impact of COVID-19 on endoscopy during the first European lockdown (March-May 2020). Methods Demographic data, patients' COVID-19 status before and after endoscopy, clinical data for those developingCOVID-19, implementation of PPM, number and type of overall endoscopies, as well as information for possible COVID-19infection of patients and PEU were retrospectively recorded. Results 1267 endoscopies (EGDs:46 %, colonoscopies/rectosigmoidoscopies:35 %, ERCPs:14 %, EUS:4 %) were performedin 1222 patients (mean age:63.4 y.o., males:59 %, inpatients:44 %) in 9 centers (6 countries). Pre-endoscopic testing forCOVID-19 was available for 326 (26.7 %) patients;87(7 %) tested positive. 7-14 days after endoscopy, 1204 patients werecontacted by telephone. Among 1135 pre-endoscopically COVID-19 negative patients 254 were tested post-endoscopy and8 were found positive (0.6 % of the total), with 6, 1 and 1 cases turning positive after EGD, colonoscopy and EUS,respectively. Of these, 4 were considered “obviously” irrelevant to endoscopy, but for the other 4 (3 post-EGD and 1 post-colonoscopy) the route of transmission remained obscure. Appropriate PPM were implemented and adhered to in allcenters;moreover, a significant reduction in the number of endoscopies was noted in all centers after March 2020. Finally,data regarding 163 PEU was recorded;5 (3 %) tested positive during the study period. In 4 of them (2 % of the total), theinfection was considered to be associated to their work environment. Conclusions COVID-19 transmission in endoscopic units is highly unlikely in a lockdown setting, provided endoscopies arereduced to emergency cases and appropriate PPM are implemented and followed.