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DOI: 10.1055/a-1380-3419
A multicenter survey on endoscopic retrograde cholangiopancreatography during the COVID-19 pandemic in northern and central Italy
Abstract
Background and study aims COVID-19 has dramatically impacted endoscopy practice because upper endoscopy procedures can be aerosol-generating. Most elective procedures have been rescheduled. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently performed in emergency or urgent settings in which rescheduling is not possible. We evaluated the impact of the COVID-19 pandemic on ERCP in Italy during the SARS-CoV-2 lockdown, in areas with high incidence of COVID-19.
Patients and methods We performed a retrospective survey of centers performing ERCP in high COVID-19 prevalence areas in Italy to collect information regarding clinical data from patients undergoing ERCP, staff, case-volume and organization of endoscopy units from March 8, 2020 to April 30, 2020.
Results We collected data from 31 centers and 804 patients. All centers adopted a triage and/or screening protocol for SARS-CoV-2 and performed follow-up of patients 2 weeks after the procedure. ERCP case-volume was reduced by 44.1 % compared to the respective 2019 timeframe. Of the 804 patients undergoing ERCP, 22 (2.7 %) were positive for COVID-19. Adverse events occurred at a similar rate to previously published data. Of the patients, endoscopists, and nurses, 1.6 %, 11.7 %, and 4.9 %, respectively, tested positive for SARS-CoV-2 at follow up. Only 38.7 % of centers had access to a negative-pressure room for ERCP.
Conclusion The case-volume reduction for ERCP during lockdown was lower than for other gastrointestinal endoscopy procedures. No definitive conclusions can be drawn about the percentage of SARS-CoV-2-positive patients and healthcare workers observed after ERCP. Appropriate triage and screening of patients and adherence to society recommendations are paramount.
Publication History
Received: 07 November 2020
Accepted: 13 January 2021
Article published online:
15 April 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
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References
- 1 Covid-19: Situazione in Italia. Available from: http://www.salute.gov.it/portale/nuovocoronavirus/homeNuovoCoronavirus.jsp?lingua=english
- 2 Li LQ, Huang T, Wang YQ. et al. COVID-19 patientsʼ clinical characteristics, discharge rate, and fatality rate of meta-analysis. J Med Virol 2020; DOI: 10.1002/jmv.25757.
- 3 Wang Y, Wang Y, Chen Y. et al. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 2020; DOI: 10.1002/jmv.25748.
- 4 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on Gastrointestinal Endoscopy and the COVID-19 Pandemic. Endoscopy 2020; 52: 483-490
- 5 Joint Gastroenterology Society Message: COVID-19 Use of Personal Protective Equipment in GI Endoscopy (AASLD, ACG, AGA. ASGE). 2020 https://www.asge.org/home/joint-gi-society-message-covid-19
- 6 Soetikno R, Teoh AYB, Kaltenbach T. et al. Considerations in performing endoscopy during the COVID-19 pandemic. Gastrointest Endosc 2020; DOI: 10.1016/j.gie.2020.03.3758.
- 7 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.
- 8 Maida M, Sferrazza S, Savarino E. et al. Impact of the COVID-19 Pandemic on Gastroenterology Divisions in Italy: A National Survey. Dig Liver Dis 2020; DOI: 10.1016/j.dld.2020.05.017.
- 9 Calderwood AH, Day LW. ASGE Quality Assurance in Endoscopy Committee. et al. ASGE guideline for infection control during GI endoscopy. Gastrointest Endosc 2018; 87: 1167-1179
- 10 Domagk D, Oppong KW, Aabakken L. et al. Performance measures for endoscopic retrograde cholangiopancreatography and endoscopic ultrasound: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. United European Gastroenterol J 2018; 6: 1448-1460
- 11 Adler DG, Lieb 2nd JG, Cohen J. et al. Quality indicators for ERCP. Gastrointest Endosc 2015; 81: 54-66
- 12 Kapral C, Mühlberger A, Wewalka F. et al. Quality assessment of endoscopic retrograde cholangiopancreatography: results of a running nationwide Austrian benchmarking project after 5 years of implementation. Eur J Gastroenterol Hepatol 2012; 24: 1447-1454
- 13 Mariani A, Segato S, Anderloni A. et al. Prospective evaluation of ERCP performance in an Italian regional database study. Dig Liver Dis 2019; 51: 978-984