IMPACT OF THE COVID-19 PANDEMIC ON UPPER GASTROINTESTINAL ENDOSCOPY ACTIVITY

Aims The Coronavirus-disease-2019 (COVID19) pandemic has clearly disrupted healthcare systems. Gastrointestinal endoscopy has been affected as well. This study aimed to evaluate the effect on upper gastrointestinal endoscopy (UGE) activity in terms of volume alongside indications and results.

Methods We conducted a single-centre retrospective study, including all UGE, over a period of eight months. We defined two phases: pre-pandemic (November2019-February2020) and 1^st pandemic wave (March2020-June2020).

Results Four hundred and eighteen patients with a mean age 49.5 years±17.1 years were included, of which 57.4% were female. Comparing the pandemic phase to baseline, the number of UGE declined of 29.4% (245 vs 173). There was a significant drop in outpatients’ proportion undergoing UGE (73.5% to 49.7%, p<0.01). However, the volume of urgent endoscopy did not change (16.3-18.5%, p=0.56). Regarding UGE indications, the followings did not vary significantly: gastrointestinal bleeding (15.1-15.6%, p=0.50), caustic ingestion (0.4-1.2%, p=0.37), epigastric pain (51.7-54.3%, p=0.69), diarrhoea (4.8-4.3%, p=1.00), dysphagia (10.9-8.5%, p=0.54) and anaemia (15-18.1%, p=0.52). Nevertheless, a mild decline in gastroesophageal-reflux-dictated UGE was observed (-6.4%, p=0.03) along with a rise in vomiting-driven UGE (+8%, p=0.02). Furthermore, variceal surveillance proportion increased (+31.3%, p<0.01) while monitoring Helicobacter Pylori eradication endoscopically diminished markedly (-29.6%, p<0.01). Concerning UGE findings, compared to benchmark, no significant dissimilarity was found: normal UGE (12.9-12.9%, p=0.99), erythematous mucosa (47.1-44.4%, p=0.59), reflux oesophagitis (7.5-6.4%, p=0.68), peptic ulcer (15.8-9.9%, p=0.08), portal-hypertension signs (9.2-14.8%, p=0.08) and tumour (0.8-2.3%, p=0.24).

Conclusions COVID19 pandemic lessened UGE volume and moulded its indications to a relatively different distribution, without influencing the endoscopic findings.

Publication History

Article published online:
14 April 2022