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DOI: 10.1055/a-1264-7599
Gastrointestinal endoscopy during the coronavirus pandemic in the New York area: results from a multi-institutional survey
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Abstract
Background and study aims The coronavirus disease 2019 (COVID-19), and measures taken to mitigate its impact, have profoundly affected the clinical care of gastroenterology patients and the work of endoscopy units. We aimed to describe the clinical care delivered by gastroenterologists and the type of procedures performed during the early to peak period of the pandemic.
Methods Endoscopy leaders in the New York region were invited to participate in an electronic survey describing operations and clinical service. Surveys were distributed on April 7, 2020 and responses were collected over the following week. A follow-up survey was distributed on April 20, 2020. Participants were asked to report procedure volumes and patient characteristics, as well protocols for staffing and testing for COVID-19.
Results Eleven large academic endoscopy units in the New York City region responded to the survey, representing every major hospital system. COVID patients occupied an average of 54.5 % (18 – 84 %) of hospital beds at the time of survey completion, with 14.5 % (2 %-23 %) of COVID patients requiring intensive care. Endoscopy procedure volume and the number of physicians performing procedures declined by 90 % (66 %-98 %) and 84.5 % (50 %-97 %) respectively following introduction of restricted practice. During this period the most common procedures were EGDs (7.9/unit/week; 88 % for bleeding; the remainder for foreign body and feeding tube placement); ERCPs (5/unit/week; for cholangitis in 67 % and obstructive jaundice in 20 %); Colonoscopies (4/unit/week for bleeding in 77 % or colitis in 23 %) and least common were EUS (3/unit/week for tumor biopsies). Of the sites, 44 % performed pre-procedure COVID testing and the proportion of COVID-positive patients undergoing procedures was 4.6 % in the first 2 weeks and up to 19.6 % in the subsequent 2 weeks. The majority of COVID-positive patients undergoing procedures underwent EGD (30.6 % COVID +) and ERCP (10.2 % COVID +).
Conclusions COVID-19 has profoundly impacted the operation of endoscopy units in the New York region. Our data show the impact of a restricted emergency practice on endoscopy volumes and the proportion of expected COVID positive cases during the peak time of the pandemic.
Publikationsverlauf
Eingereicht: 25. Juni 2020
Angenommen: 20. August 2020
Artikel online veröffentlicht:
27. November 2020
© 2020. 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 commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 World Health Organization. COVID-19 Situation Report. Situation Report -114. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200513-covid-19-sitrep-114.pdf?sfvrsn=17ebbbe_4 Published May 13, 2020. Accessed May 14, 2020.
- 2 Li R, Pei S, Chen B. et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science 2020; 368: 489-493
- 3 Wadhera RK, Wadhera P, Gaba P. et al. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs. JAMA 2020; 323: 2192-2195
- 4 Joint GI society message: COVID-19 clinical insights for our community of gastroenterologists and gastroenterology care providers. https://www.asge.org/home/joint-gi-society-message-covid-19 Accessed May 14, 2020
- 5 Sethi A, Swaminath A, Latorre M. et al. Donning a new approach to the practice of gastroenterology: perspectives from the COVID-19 pandemic epicenter. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc 2020; 18: 1673-1681
- 6 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology 2020; 158: 1518-1519
- 7 Xiao F, Tang M, Zheng X. et al. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology 2020; 158: 1831-1833.e3
- 8 Carr-Locke DL, Soetikno R, Sharaiha RZ. Whatever happened to universal/standard precautions?. Gastrointest Endosc 2020; 92: 399-400
- 9 Repici A, Maselli R, Colombo M. et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Gastrointest Endosc 2020; 92: 192-197
- 10 Kamerow D. Covid-19: the crisis of personal protective equipment in the US. BMJ 2020; 369: m1367
- 11 Repici A, Pace F, Gabbiadini R. et al. Endoscopy units and the COVID-19 outbreak: a multi-center experience from Italy. Gastroenterology 2020; 159: 363-366.e3
- 12 Forbes N, Smith ZL, Spitzer RL. et al. Changes in gastroenterology and endoscopy practices in response to the COVID-19 Pandemic: results from a North American survey. Gastroenterology 2020; 159: 772-774.e13
- 13 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. Gastrointest Endosc 2020; 92: 788-789
- 14 Bilal M, Simons M, Rahman AU. et al. What constitutes urgent endoscopy? A social media snapshot of gastroenterologists’ views during the COVID-19 pandemic. Endosc Int Open 2020; 8: E693-E698
- 15 Sawhney MS, Bilal M, Pohl H. Triaging advanced GI endoscopy procedures during the COVID-19 Pandemic: consensus recommendations using the Delphi method. Gastrointest Endoscop 2020; 92: 535-542
- 16 Hajifathalian K, Krisko T, Mehta A. et al. Gastrointestinal and Hepatic Manifestations of 2019 Novel Coronavirus Disease in a Large Cohort of Infected Patients From New York: Clinical Implications. Gastroenterology 2020; 159: 1137-1140.e2
- 17 Repici A, Aragona G, Cengia G. et al. Low risk of covid-19 transmission in GI endoscopy. Gut 2020; DOI: 10.1136/gutjnl-2020-321341.
- 18 Hennessy B, Vicari J, Bernstein B. et al. Guidance for resuming GI endoscopy and practice operations after the COVID-19 pandemic. Gastrointest Endosc 2020; 92: 743-747.e1