Impact of the COVID-19 pandemic on endoscopy practice: results of a cross-sectional survey from the New York metropolitan area

Mahadev, Sri Hari; Aroniadis, Olga S.; Barraza, Luis H.; Agarunov, Emil; Goodman, Adam; Benias, Petros C.; Buscaglia, Jonathan M.; Gross, Seth A.; Kasmin, Franklin; Cohen, Jonathan; Carr‐Locke, David L.; Greenwald, David A.; Mendelsohn, Robin B.; Sethi, Amrita; Gonda, Tamas A.

doi:10.1016/j.gie.2020.04.047

Cited by 28 publications

(36 citation statements)

References 2 publications

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“…Many endoscopists reported that use of FFP-2/3 masks was restricted to known or suspected COVID-19 cases due to limited availability (17%) or were not available at all (9%). 17 Results of our survey carried out 6 weeks after the onset of COVID-19 pandemic in Hungary showed great similarity to the ndings of this study. The appropriate amount and quality PPE were available in 60.83%…”

Section: Discussionsupporting

confidence: 84%

Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary - a cross-sectional survey

Bor

Szántó

Fábián

et al. 2020

Preprint

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Background Health care professionals in endoscopic labs have an elevated risk for COVID-19 infection, therefore, we aimed to determine the effect of current pandemic on the workflow and infection prevention and control strategies of endoscopy units in real-life setting. Methods All members of Hungarian Society of Gastroenterology were invited between 7 and 17 April 2020 to participate in this cross-section survey study and to complete an online, anonymous questionnaire. Results Total of 120 endoscopists from 83 institutes were enrolled of which 35.83% worked in regions with high cumulative incidence of COVID-19. Only 33.33% of them had undergone training about infection prevention in their workplace. 95.83% of endoscopists regularly used risk stratification of patients for infection prior endoscopy. While indications of examinations in low risk patients varied widely, in high-risk or positive patients endoscopy was limited to gastrointestinal bleeding (95.00%), removal of foreign body from esophagus (87.50%), management of obstructive jaundice (72.50%) and biliary pancreatitis (67.50%). Appropriate amount of personal protective equipment was available in 60.85% of endoscopy units. In high-risk or positive patients, surgical mask, filtering facepiece mask, protective eyewear and two pairs of gloves were applied in 30.83%, 76.67%, 90.00% and 87.50% of cases, respectively. Personal protective equipment fully complied with European guideline only in 67.50% of cases. Conclusions Survey found large variability in indications of endoscopy and relative weak compliance to national and international practical recommendations in terms of protective equipment. This could be improved by adequate training about infection prevention.

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Section: Discussionsupporting

confidence: 84%

Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary - a cross-sectional survey

Bor

Szántó

Fábián

et al. 2020

Preprint

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“…In our survey, we observed that most respondents are using N95 masks (74.7 %) and/or complete PPE (49.2 %) while performing endoscopic procedures. In the study by Mahadev S et al [7], only 65 % of endoscopists used N95 respiratory masks for all cases universally since the onset of COVID-19 in New York. The main reason for this was limited availability (17 %) or no available of the masks at all (9 %).…”

Section: Discussionmentioning

confidence: 99%

“…A recent electronic survey conducted in the New York metropolitan area by Mahadev S et al showed that COVID-19 has drastically impacted endoscopy practice and procedure volumes. Since the onset of COVID-19, 71 % of gastroenterologists in New York reported that they are no longer regularly performing endoscopy, and 62 % reported zero cases over the 7 days preceding the survey [7].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…This multicenter study describes the characteristics and outcomes of all adult patients undergoing endoscopy at six academic hospitals in New York City during the peak of the COVID-19 pandemic in early 2020. As described in a New York Society of Gastrointestinal Endoscopy survey, the number of routine endoscopy cases significantly decreased in our region during the pandemic [2]. Many gastroenterologists stopped performing endoscopies completely during the peak of the pandemic.…”

Section: Discussionmentioning

confidence: 87%

“…The novel coronavirus pandemic brought routine endoscopy in many areas of the world to a near halt, particularly in New York City, one of the major epicenters of the crisis in early 2020 [1]. It has disrupted scheduled cancer screenings, care of inflammatory bowel disease patients, and evaluation of iron deficiency anemia, among other common gastrointestinal problems [2,3]. Fellow education has also been adversely affected as a result of the sharp drop in endoscopy volume.…”

Section: Introductionmentioning

confidence: 99%

Characteristics and Outcomes of Patients Undergoing Endoscopy During the COVID-19 Pandemic: A Multicenter Study from New York City

et al. 2020

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Background The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the practice of endoscopy, but characteristics of COVID patients undergoing endoscopy have not been adequately described. Aims To compare findings, clinical outcomes, and patient characteristics of endoscopies performed during the pandemic in patients with and without COVID-19. Methods This was a retrospective multicenter study of adult endoscopies at six academic hospitals in New York between March 16 and April 30, 2020. Patient and procedure characteristics including age, sex, indication, findings, interventions, and outcomes were compared in patients testing positive, negative, or untested for COVID-19. Results Six hundred and five endoscopies were performed on 545 patients during the study period. There were 84 (13.9%), 255 (42.2%), and 266 (44.0%) procedures on COVID-positive, negative, and untested patients, respectively. COVID patients were more likely to undergo endoscopy for gastrointestinal bleeding or gastrostomy tube placement, and COVID patients with gastrointestinal bleeding more often required hemostatic interventions on multivariable logistic regression. COVID patients had increased length of stay, intensive care unit admission, and intubation rate. Twenty-seven of 521 patients (5.2%) with no or negative COVID testing prior to endoscopy later tested positive, a median of 13.5 days post-procedure. Conclusions Endoscopies in COVID patients were more likely to require interventions, due either to more severe illness or a higher threshold to perform endoscopy. A significant number of patients endoscoped without testing were subsequently found to be COVID-positive. Gastroenterologists in areas affected by the pandemic must adapt to changing patterns of endoscopy practice and ensure pre-endoscopy COVID testing.

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Impact of the COVID-19 pandemic on endoscopy practice: results of a cross-sectional survey from the New York metropolitan area

Cited by 28 publications

References 2 publications

Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary - a cross-sectional survey

Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary - a cross-sectional survey

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

Characteristics and Outcomes of Patients Undergoing Endoscopy During the COVID-19 Pandemic: A Multicenter Study from New York City

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