Impact of COVID-19 on gastrointestinal endoscopy practice in India: a cross-sectional study

Abstract

Background and study aims Gastrointestinal endoscopy, being an aerosol-generating procedure, has the potential to transmit Severe Acute Respiratory Distress Syndrome Corona Virus-2 (SARS-CoV-2) during the current pandemic. Adequate knowledge is the key to prevention. A survey, perhaps the first, was conducted among Indian endoscopists to assess the impact of Coronavirus Disease (COVID)-19 on gastroinestinal endoscopy practice in the country. Methods From April 24 to 28, 2020, an electronic survey (using Google Form) was conducted with 23 questions (single or multiple answers) on: (1) endoscopy practice before the pandemic; (2) knowledge about COVID-19; and (3) its impact on endoscopy practice. Results Responses were received from 375 of 1205 (31.1 %) endoscopists. Most (35.7 %) were young (31–40 years), practicing in corporate multi-speciality hospitals (44.6 %) or independent practice set-up (17.7 %) in metropolitan cities (55.6 %) and urban areas (42.3 %). In most units (75.4 %), fewer than 10 % of procedures performed are endoscopies, as compared to before the pandemic. A reduction in volume of endoscopy related to restriction of the routine procedures by the latest guideline was reported by 86.9 % of respondents. Most are using N95 masks (74.7 %) and/or complete personal protective equipment (PPE, 49.2 %) during endoscopic procedures. Only 18.3 % of respondents had access to negative pressure rooms either within (5.4 %) or outside (12.9 %) the usual endoscopy suite. Conclusion Endoscopy units in India are performing fewer than 10 % of their usual volumes due to current restrictions. Resources to follow current international guidelines, including use of negative pressure rooms and PPE, are limited. Alternate measures are needed to keep up the services.

COVID‐19 prevalence among health‐care workers of Gastroenterology department: An audit from a tertiary‐care hospital in India

“…Gastroenterology and endoscopy practice in our country has gone through three phases in the current pandemic. In the first 2 months of nationwide lockdown, that is, mid‐March to mid‐May 2020, there was a significant decrease (by almost 10% compared to that in the pre‐COVID‐19 era) in the frequency of endoscopy all over the country, as shown by our nationwide survey 20 . During the gradual “unlocking” procedure, that is, later part of May to mid‐July, most of the endoscopy services were triaging the patients on the basis of suspicion of COVID‐19, with those having relevant symptoms or history of contact with individuals subjected to PCR testing.…”

Current understanding of the impact of COVID-19 on gastrointestinal disease: Challenges and openings

“…The alarming element concerning COVID-19 is its airborne transmission that may also be feasible in some medical circumstances. Certain clinical practices such as endotracheal intubation, bronchoscopy, nebulization etc , produces aerosols resulting in aerial spread, while fecal-oral route transmission (fomites) can also result in contamination[ 82 , 83 ].…”

Clinical Impact of Universal Screening for COVID-19 before Therapeutic Endoscopy

“…5,6 The prioritization of GI endoscopy according to protocols and indications has resulted in endoscopic centers to operate at less than 25% of normal volume. 3,[7][8][9] As endoscopic procedures are considered to be aerosol-generating procedures, guidelines have advised screening of all patients for COVID-19 prior to endoscopy, in order to prevent COVID-19 transmission. 1,2,6,10 There is risk of transmission of COVID-19 infection from asymptomatic carriers who need endoscopic intervention to health care workers.…”