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
The coronavirus disease 2019 (COVID-19) outbreak significantly affected endoscopic practice, as gastrointestinal endoscopy is considered as a risky procedure for transmission of infection. The ESGE and ESGENA published a position statement for endoscopy during the COVID-19 pandemic regarding the safety of endoscopies for patients and the personnel of endoscopy units (PEU). However, the incidence and outcome of infection among patients undergoing endoscopy and PEU remains to be determined.
Currently, there is insufficient data regarding the incidence and outcomes of COVID-19 infection among patients undergoing endoscopy and in PEU.
We aimed to evaluate the impact of endoscopic procedures on the risk of transmission to patients and PEU in a European multicenter study, using telephone contact as a tool as suggested by the ESGE and ESGENA.
Patients undergoing endoscopy in nine endoscopy departments across six European countries during the period of the first European lockdown for COVID-19 (March-May 2020) were included. Participants were stratified as low- or high-risk for potential COVID-19 infection according to the ESGE/ESGENA joint statement were contacted 7 d and 14 d later to assess COVID-19 infection status. PEU were questioned regarding COVID-19 symptoms and/or infection by questionnaire. Information on hospitalizations, ICU-admissions, and COVID-19-related deaths were collected. The number of weekly endoscopies during the lockdown period was also recorded.
A total of 1267 endoscopies were performed in 1222 individuals; 87 (7%) were excluded following initial positive PCR testing. The remaining 1135 individuals were at low risk or PCR negative for COVID-19 before endoscopy, and of 254 (22.4%) who were tested post endoscopy, eight were eventually found positive, resulting in an infection rate of 0.7% (95%CI: 0.2-0.12). The majority, (6/8, 75%) had undergone esophagogastroduodenoscopy. Data were available for 163 PEU, and 5 (3%; 95%CI: 0.4-5.7) tested positive during the study period. In 4 of the 5, or 2% of the total, the infection was deemed relevant to their work environment. A decrease of 68.7% (95%CI: 64.8-72.7) in the number of endoscopies was recorded.
This study showed that COVID-19 transmission in endoscopic units was highly unlikely during a lockdown setting, provided endoscopies were restricted to emergency cases and PPM were implemented.
More robust data are definitely warranted to identify various clinical factors that contribute to an increased risk of endoscopy-related COVID-19 infection.