Impact of COVID-19 on gastrointestinal endoscopy practice in India: a cross-sectional study
Background and study aims Gastrointestinal endoscopy, being an aerosol-generating procedure, has the potential to transmit Severe Acute Respiratory Distress Syndrome Corona Virus-2 (SARS-CoV-2) during the current pandemic. Adequate knowledge is the key to prevention. A survey, perhaps the first, was conducted among Indian endoscopists to assess the impact of Coronavirus Disease (COVID)-19 on gastroinestinal endoscopy practice in the country.
Methods From April 24 to 28, 2020, an electronic survey (using Google Form) was conducted with 23 questions (single or multiple answers) on: (1) endoscopy practice before the pandemic; (2) knowledge about COVID-19; and (3) its impact on endoscopy practice.
Results Responses were received from 375 of 1205 (31.1 %) endoscopists. Most (35.7 %) were young (31–40 years), practicing in corporate multi-speciality hospitals (44.6 %) or independent practice set-up (17.7 %) in metropolitan cities (55.6 %) and urban areas (42.3 %). In most units (75.4 %), fewer than 10 % of procedures performed are endoscopies, as compared to before the pandemic. A reduction in volume of endoscopy related to restriction of the routine procedures by the latest guideline was reported by 86.9 % of respondents. Most are using N95 masks (74.7 %) and/or complete personal protective equipment (PPE, 49.2 %) during endoscopic procedures. Only 18.3 % of respondents had access to negative pressure rooms either within (5.4 %) or outside (12.9 %) the usual endoscopy suite.
Conclusion Endoscopy units in India are performing fewer than 10 % of their usual volumes due to current restrictions. Resources to follow current international guidelines, including use of negative pressure rooms and PPE, are limited. Alternate measures are needed to keep up the services.
Received: 06 May 2020
Accepted: 11 May 2020
18 June 2020 (online)
© 2020. Owner and Copyright ©
© Georg Thieme Verlag KG
Stuttgart · New York
- 1 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential faecal-oral transmission. Gastroenterology 2020; 6: 1518-1519
- 2 Xiao F, Tang M, Zheng X. et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020; 6: 1831-1833
- 3 Repici A, Aragona G, Cengia G. et al. Low risk of covid-19 transmission in GI endoscopy. Gut 2020; 321-341
- 4 Thompson CC, Shen L, Lee LS. COVID-19 in Endoscopy: Time to do more?. Gastrointes Endosc 2020; DOI: 10.1016/j.gie.2020.03.3848.
- 5 Johnston ER, Habib-Bein N, Dueker JM. et al. Risk of bacterial exposure to the endoscopists face during endoscopy. Gastrointest Endosc 2019; 89: 818-824
- 6 Wong TW, Lee CK, Tam W. et al. Cluster of SARS amongmedical students exposed to single patient, Hong Kong. Emerg Infect Dis 2004; 10: 269-276
- 7 Mahadev S, Aroniadis OS, Barraza L. et al. Impact of the COVID-19 pandemic on endoscopy practice: results of a cross-sectional survey from the New York metropolitan area (Article in press). Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.04.047.
- 8 Soetikno R, Teoh AY, Kaltenbach T. et al. Considerations in performing endoscopy during the COVID-19 pandemic. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.03.3758.
- 9 American Society for Gastrointestinal Endoscopy. Joint gastroenterology society message: COVID-19 use of personal protective equipment in GI endoscopy. Gastrointest Endosc; 2020 https://gi.org/2020/03/15/joint-gi-society-message-on-covid-19/
- 10 Lui RN, Wong SH, Sánchez-Luna SA. et al. Overview of guidance for endoscopy during the coronavirus disease 2019 (COVID‐19) pandemic. J Gastroenterol Hepatol 2020; DOI: 10.1111/jgh.15053.
- 11 Philip M, Lakhtakia S, Aggarwal R. et al. Joint Guidance from SGEI, ISG and INASL for Gastroenterologists and Gastrointestinal Endoscopists on the Prevention, Care and Management of patients with COVID-19. J Clin Exp Hepatol 2020; DOI: 10.1016/j.jceh.2020.04.001.
- 12 Chiu PW, Ng SC, Inoue H. et al. Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut 2020; DOI: 10.1136/gutjnl-2020-321185.
- 13 Lui RN, Wong SH, Sánchez-Luna SA. et al. Overview of guidance for endoscopy during the coronavirus disease 2019 (COVID‐19) pandemic. J Gastroenterol Hepatol 2020; 35: 749-759
- 14 He X, Lau EH, Wu P. et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med 2020; DOI: 10.1038/s41591-020-0869-5.
- 15 Sultan S, Lim JK, Altayar O. et al. AGA Institute rapid recommendations for gastrointestinal procedures during the COVID-19 pandemic. Gastroenterology 2020; DOI: 10.1053/j.gastro.2020.03.072.
- 16 Repici A, Maselli R, Colombo M. et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.03.019.
- 17 Zacharias P, Mathew S, Mathews J. et al. Sedation practices in gastrointestinal endoscopy-A survey from southern India. Indian J Gastroenterol 2018; 37: 164-168