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3.
Am J Gastroenterol ; 116(6): 1345-1349, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1194822

ABSTRACT

INTRODUCTION: To assess beliefs about safety, effectiveness, and delivery of the coronavirus disease 2019 (COVID-19) vaccine among chronic Gastroenterology and Hepatology patients at an academic health system. METHODS: We asked about vaccine beliefs, vaccine concerns, and preferred location to receive the COVID-19 vaccine. RESULTS: A total of 1,215 patients responded (response rate: 37%). Most patients believed that vaccines are safe, effective, and that they would take the COVID-19 vaccine at a medical office or pharmacy. However, we identified important sociodemographic factors associated with vaccine hesitancy. DISCUSSION: Patients have high level of trust in the COVID-19 vaccine and are likely to follow their specialist physician recommendations.


Subject(s)
COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Health Knowledge, Attitudes, Practice , Vaccination/psychology , Adult , Aged , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/adverse effects , Chronic Disease , Female , Gastroenterology/statistics & numerical data , Humans , Male , Middle Aged , SARS-CoV-2/immunology , Socioeconomic Factors , Surveys and Questionnaires/statistics & numerical data , Vaccination/adverse effects , Vaccination/statistics & numerical data
4.
Dig Liver Dis ; 53(6): 682-688, 2021 06.
Article in English | MEDLINE | ID: covidwho-1120261

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic has had a huge impact on healthcare systems, resulting in many routine diagnostic procedures either being halted or postponed. AIMS: To evaluate whether the diagnoses of colorectal, gastric and pancreatic cancers have been impacted by the SARS-CoV-2 pandemic in Italy. METHODS: A survey designed to collect the number of histologically-proven diagnoses of the three cancers in gastroenterology services across Italy from January 1 to October 31 in 2017-2020. Non-parametric ANOVA for repeated measurements was applied to compare distributions by years and macro-areas. RESULTS: Compared to 2019, in 2020 gastric cancer diagnoses decreased by 15.9%, CRC by 11.9% and pancreatic by 9.9%. CRC distributions showed significant differences between all years, stomach cancer between 2018 and 2020 and 2019-2020, and pancreatic cancer only between 2017 and 2019. The 2019-2020 comparison showed fewer CRC diagnoses in the North (-13.7%), Center (-16.5%) and South (-4.1%), fewer stomach cancers in the North (-19.0%) and South (-9.4%), and fewer pancreatic cancers in the North (-14.1%) and Center (-4.7%), with an increase in the South (+12.3%). Distributions of CRC and gastric cancer were significantly different between all years in the North. CONCLUSIONS: This survey highlights the concerning effects of the COVID-19 pandemic on the diagnostic yield of gastroenterology services for stomach, colorectal and pancreatic cancers in Italy.


Subject(s)
COVID-19 , Delivery of Health Care , Digestive System Neoplasms , Early Detection of Cancer , COVID-19/epidemiology , COVID-19/prevention & control , Delivery of Health Care/organization & administration , Delivery of Health Care/trends , Diagnostic Techniques, Digestive System , Digestive System Neoplasms/diagnosis , Digestive System Neoplasms/epidemiology , Early Detection of Cancer/methods , Early Detection of Cancer/trends , Gastroenterology/methods , Gastroenterology/statistics & numerical data , Humans , Infection Control/methods , Italy/epidemiology , Organizational Innovation , SARS-CoV-2 , Surveys and Questionnaires
5.
J Gastroenterol Hepatol ; 36(6): 1627-1633, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-975558

ABSTRACT

BACKGROUND AND AIM: Significant human and material resources have been diverted to coronavirus disease 2019 (COVID-19). Healthcare workers are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We assess the impact of the COVID-19 pandemic on gastroenterology and hepatology departments and specialists in Spain. METHODS: This study involves a nationwide survey addressing the impact of COVID-19 on resources, procedures, and physicians of gastroenterology and hepatology departments in 81 hospitals representative of the Spanish National Health Service. RESULTS: Overall, 41.8% of hospital beds and 40.7% of gastroenterology and hepatology beds were allocated to COVID-19 patient care, as well as 24.8% of gastroenterologists and 58.3% of residents. Outpatient visits, abdominal ultrasounds, and endoscopies were reduced by 81.8-91.9%. Nine large university hospitals had 75% and 89% reductions in therapeutic endoscopies and hepatocellular carcinoma surgery, respectively, with cancelation of elective liver transplant and transjugular intrahepatic portosystemic shunt. Prevalence of infected physicians was 10.6% and was dependent on regional population incidence (r = 0.74, P = 0.001), with 11% hospitalized and one physician dying. Up to 63.4% of physicians may have been infected before or shortly after Spain entered lockdown, 57% of them having recently performed endoscopies. Adequate protection was acknowledged in > 80% hospitals, but only 2.9% performed regular SARS-CoV-2 testing. CONCLUSIONS: The impact of the COVID-19 pandemic on healthcare delivery has been massive. A wave of gastroenterology-related complications is expected because of resource diversion. Gastroenterologists have a high prevalence of infection, although they may have been infected during a first phase of lower awareness and protection. Regular SARS-CoV-2 screening, adequate protection, and quick reorganization of healthcare resources are still needed.


Subject(s)
COVID-19 , Gastroenterology , Gastrointestinal Diseases , Health Personnel , Occupational Exposure , Attitude of Health Personnel , COVID-19/epidemiology , COVID-19/prevention & control , Digestive System Surgical Procedures/statistics & numerical data , Endoscopy, Gastrointestinal/statistics & numerical data , Gastroenterology/methods , Gastroenterology/organization & administration , Gastroenterology/statistics & numerical data , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Health Care Surveys , Health Personnel/psychology , Health Personnel/statistics & numerical data , Hospital Departments/statistics & numerical data , Humans , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Needs Assessment , Occupational Exposure/prevention & control , Occupational Exposure/standards , Organizational Innovation , SARS-CoV-2 , Spain/epidemiology
7.
Dig Dis Sci ; 66(10): 3307-3311, 2021 10.
Article in English | MEDLINE | ID: covidwho-871506

ABSTRACT

BACKGROUND: The COVID-19 pandemic has impacted numerous facets of healthcare workers' lives. There have also been significant changes in Gastroenterology (GI) fellowship training as a result of the challenges presented by the pandemic. AIMS: We conducted a national survey of Gastroenterology fellows to evaluate fellows' perceptions, changes in clinical duties, and education during the pandemic. METHODS: A survey was sent to Gastroenterology (GI) fellows in the USA. Information regarding redeployment, fellow restriction in endoscopy, outpatient clinics and inpatient consults, impact on educational activities, and available wellness resources was obtained. Fellows' level of agreement with adjustments to clinical duties was also assessed. RESULTS: One hundred and seventy-seven Gastroenterology fellows responded, and 29.4% were redeployed to non-GI services during the pandemic. COVID-19 impacted all aspects of GI fellowship training in the USA (endoscopy, outpatient clinics, inpatient consults, educational activities). Fellows' level of agreement in changes to various aspects of fellowship varied. 72.5% of respondents reported that their programs provided them with increased wellness resources to cope with the additional stress during the pandemic. For respondents with children, 17.6% reported no support with childcare. CONCLUSIONS: Our results show that the COVID-19 pandemic has impacted GI fellowship training in the USA in multiple domains, including gastrointestinal endoscopy, inpatient consults, outpatient clinics, and educational conferences. Our study highlights the importance of considering and incorporating fellows' viewpoints, as changes are made in response to the ongoing pandemic.


Subject(s)
COVID-19 , Gastroenterologists/statistics & numerical data , Gastroenterology/education , Adult , Fellowships and Scholarships/statistics & numerical data , Female , Gastroenterology/statistics & numerical data , Humans , Male , Surveys and Questionnaires
8.
PLoS One ; 15(10): e0240397, 2020.
Article in English | MEDLINE | ID: covidwho-841010

ABSTRACT

BACKGROUND: There is a need to understand the impact of COVID-19 on colorectal cancer care globally and determine drivers of variation. OBJECTIVE: To evaluate COVID-19 impact on colorectal cancer services globally and identify predictors for behaviour change. DESIGN: An online survey of colorectal cancer service change globally in May and June 2020. PARTICIPANTS: Attending or consultant surgeons involved in the care of patients with colorectal cancer. MAIN OUTCOME MEASURES: Changes in the delivery of diagnostics (diagnostic endoscopy), imaging for staging, therapeutics and surgical technique in the management of colorectal cancer. Predictors of change included increased hospital bed stress, critical care bed stress, mortality and world region. RESULTS: 191 responses were included from surgeons in 159 centers across 46 countries, demonstrating widespread service reduction with global variation. Diagnostic endoscopy was reduced in 93% of responses, even with low hospital stress and mortality; whilst rising critical care bed stress triggered complete cessation (p = 0.02). Availability of CT and MRI fell by 40-41%, with MRI significantly reduced with high hospital stress. Neoadjuvant therapy use in rectal cancer changed in 48% of responses, where centers which had ceased surgery increased its use (62 vs 30%, p = 0.04) as did those with extended delays to surgery (p<0.001). High hospital and critical care bed stresses were associated with surgeons forming more stomas (p<0.04), using more experienced operators (p<0.003) and decreased laparoscopy use (critical care bed stress only, p<0.001). Patients were also more actively prioritized for resection, with increased importance of co-morbidities and ICU need. CONCLUSIONS: The COVID-19 pandemic was associated with severe restrictions in the availability of colorectal cancer services on a global scale, with significant variation in behaviours which cannot be fully accounted for by hospital burden or mortality.


Subject(s)
Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/therapy , Coronavirus Infections/epidemiology , Elective Surgical Procedures , Health Care Rationing , Pneumonia, Viral/epidemiology , Betacoronavirus/physiology , COVID-19 , Elective Surgical Procedures/statistics & numerical data , Female , Gastroenterology/organization & administration , Gastroenterology/statistics & numerical data , Health Services Needs and Demand , Humans , Male , Pandemics , Patient Safety , SARS-CoV-2
10.
Endoscopy ; 52(12): 1111-1115, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-766193

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic has majorly affected medical activity around the world. We sought to measure the impact of the COVID-19 pandemic on gastrointestinal (GI) endoscopy activity in France. METHODS: We performed a web-based survey, including 35 questions on the responders and their endoscopic practice, from 23 March to 27 March 2020, sent to the 3300 French gastroenterologists practicing endoscopy. RESULTS: 694 GI endoscopists (21 %) provided analyzable data; of these, 29.4 % (204/694) were involved in the management of COVID-19 patients outside the endoscopy department. During the study period, 98.7 % (685/694) of endoscopists had had to cancel procedures. There were 89 gastroenterologists (12.8 %) who reported symptoms compatible with COVID-19 infection, and a positive PCR test was recorded in 12/197 (6.1 %) vs. 3/497 (0.6 %) endoscopists in the high vs. low prevalence areas, respectively (P < 0.001). CONCLUSIONS: The COVID-19 pandemic led to a major reduction in the volume of GI endoscopies performed in France in March 2020. The prolonged limited access to GI endoscopy could lead to a delay in the management of patients with GI cancers.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Endoscopy, Gastrointestinal/statistics & numerical data , Gastroenterology/statistics & numerical data , Hospital Departments/statistics & numerical data , Occupational Exposure , COVID-19/diagnosis , COVID-19/prevention & control , Female , France/epidemiology , Humans , Male , Middle Aged , Pandemics , Personal Protective Equipment/supply & distribution , Prevalence , SARS-CoV-2 , Surveys and Questionnaires
11.
Dig Liver Dis ; 52(9): 937-941, 2020 09.
Article in English | MEDLINE | ID: covidwho-641652

ABSTRACT

BACKGROUND: The COVID-19 pandemic had a huge impact on national and regional health systems. The impact of SARS-CoV-2 on the quality of care for patients with liver disease is still unknown. AIMS: The Italian Association for the Study of the Liver (AISF) conducted a survey to assess the impact of SARS-CoV-2 on hepatology units activities in Italy. METHODS: A prospective web-based survey was proposed to all AISF active members. The survey was available online from April 8 2020, to May 3 2020, (lockdown phase in Italy). RESULTS: 194 AISF members answered the questionnaire, most of whom were specialists in Gastroenterology (41%) or Internal Medicine (28%), and worked in Northern Italy (51%). 26% of hepatology wards had been converted into COVID-19 wards, and 33% had bed reductions. All hepatological activities, including the management of patients with decompensated liver disease, liver transplant and HCC had been significantly reduced/stopped. The number of physicians answering that their practices had not been modified ranged between 0.6% (for chronic hepatitis) to 47% (for the execution of paracentesis). The recorded answers were consistent among different regions, and did not show any north-south gradient CONCLUSION: COVID-19 outbreak significantly impacted on hepatological clinical activity. This survey can serve as a basis to compare the impact of future measures aimed at delivering an acceptable level of liver care during a national pandemic or crisis.


Subject(s)
Ambulatory Care/statistics & numerical data , Coronavirus Infections/epidemiology , Gastroenterology/statistics & numerical data , Hospitalization/statistics & numerical data , Liver Diseases/therapy , Pneumonia, Viral/epidemiology , Antiviral Agents/therapeutic use , Betacoronavirus , COVID-19 , Carcinoma, Hepatocellular/therapy , Chronic Disease , Esophageal and Gastric Varices/diagnosis , Esophageal and Gastric Varices/surgery , Hepatitis B, Chronic/drug therapy , Hepatitis C, Chronic/drug therapy , Humans , Italy/epidemiology , Liver Cirrhosis/therapy , Liver Neoplasms/therapy , Liver Transplantation/statistics & numerical data , Mass Screening , Pandemics , Paracentesis/statistics & numerical data , Quality of Health Care , SARS-CoV-2 , Surveys and Questionnaires
15.
Dig Liver Dis ; 52(8): 808-815, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-276436

ABSTRACT

BACKGROUND: In Italy, the spread of the COVID-19 pandemic has stressed the entire healthcare system and required a huge re-organization of many Divisions, including those of Gastroenterology. AIMS: to assess the impact of COVID-19 pandemic on Gastroenterology Divisions across Italy. METHODS: All members of the Italian Society of Gastroenterology (SIGE) were invited to answer a web-based survey. RESULTS: Data of 121 hospitals from all 20 Italian regions were analyzed. Overall, 10.7% Gastroenterology Divisions have been converted to Covid Units. Outpatients consultations, endoscopic and ultrasound procedures were limited to urgencies and oncology indications in 85.1%, 96.2% and 72.2% of Units, respectively, and 46.7% of them suspended the screening for colorectal cancer. Moreover, 72.2% of the staff received a training for use of personal protective equipment, although 45.5% did not have sufficient devices for adequate replacement. Overall, 132 healthcare workers in 41 Gastroenterology Divisions were found to be infected. CONCLUSION: This is the first study to evaluate, at a country level, the impact of COVID-19 outbreak on Gastroenterology Divisions. Substantial changes of practice and reduction of procedures have been recorded in the entire country. The long-term impact of such modifications is difficult to estimate but potentially very risky for many digestive diseases.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/methods , Gastroenterology/statistics & numerical data , Gastroenterology/standards , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Betacoronavirus , COVID-19 , Coronavirus Infections/transmission , Health Personnel , Hospitals , Humans , Infection Control/methods , Italy/epidemiology , Personal Protective Equipment/standards , Pneumonia, Viral/transmission , SARS-CoV-2 , Surveys and Questionnaires
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