Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.416
Peer-review started: February 25, 2021
First decision: April 18, 2021
Revised: April 27, 2021
Accepted: July 21, 2021
Article in press: July 21, 2021
Published online: September 16, 2021
Coronavirus disease 2019 (COVID-19) significantly affected endoscopy practice, as gastrointestinal endoscopy is considered a risky procedure for transmission of infection to patients and personnel of endoscopy units (PEU).
To assess the impact of COVID-19 on endoscopy during the first European lockdown (March-May 2020).
Patients undergoing endoscopy in nine endoscopy units across six European countries during the period of the first European lockdown for COVID-19 (March-May 2020) were included. Prior to the endoscopy procedure, participants were stratified as low- or high- risk for potential COVID-19 infection according to the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) joint statement, and contacted 7-14 d later to assess COVID-19 infection status. PEU were questioned regarding COVID-19 symptoms and/or infection via questionnaire, while information regarding hospitalizations, intensive care unit-admissions and COVID-19-related deaths were collected. The number of weekly endoscopies at each center during the lockdown period was also recorded.
A total of 1267 endoscopies were performed in 1222 individuals across nine European endoscopy departments in six countries. Eighty-seven (7%) were excluded because of initial positive testing. Of the 1135 pre-endoscopy low risk or polymerase chain reaction negative for COVID-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 of the 8 patients, 75%) had undergone esophagogastroduodenoscopy. Of the 163 PEU, 5 [3%; (95%CI: 0.4-5.7)] tested positive during the study period. 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.
COVID-19 transmission in endoscopy units is highly unlikely in a lockdown setting, provided endoscopies are restricted to emergency cases and PPM are implemented.
Core Tip: The Coronavirus disease 2019 (COVID-19) pandemic outbreak caused an unprecedented disruption in everyday endoscopy practice worldwide, with recent guidelines advocating suspension of nonemergency endoscopies, implementation of strict personal protection measures (PPM) and post-endoscopy evaluation of patient COVID-19 status. This was an international multicenter study seeking to evaluate the impact of COVID-19 on endoscopy during the first European lockdown (March-May 2020). COVID-19 transmission across endoscopic units proved to be highly unlikely in lockdown circumstances as long as endoscopy performance was restricted to emergency cases and sufficient PPM are available.