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Changes in endoscopic patterns before and during COVID-19 outbreak: Experience at a single tertiary center in Korean
Kook Hyun Kim1, Sung Bum Kim2, Tae Nyeun Kim2
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea. kimkh@yu.ac.kr.
Insights
The COVID-19 pandemic significantly reduced emergency gastrointestinal endoscopy procedures. This study found a substantial drop in endoscopies and a shift in patient presentation during the outbreak.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic necessitated changes in hospital policies to protect staff and prevent viral spread.
- The specific impact of COVID-19 on emergency gastrointestinal endoscopy services remained unclear.
Purpose of the Study:
- To compare the volume and types of emergency endoscopic procedures performed before and during the COVID-19 outbreak.
- To analyze clinical outcomes and indications for emergency endoscopies during the pandemic.
Main Methods:
- A retrospective cohort study analyzed emergency endoscopy data from a tertiary hospital in Daegu, South Korea.
- Data from February 18 to March 28, 2020, were compared with the same periods in 2018 and 2019.
- Patient demographics, laboratory findings, indications, and endoscopic findings were reviewed.
Main Results:
- A total of 366 emergency endoscopic procedures were performed during the study period in 2020.
- The number of procedures decreased by 48.8% and 54.8% compared to 2018 and 2019, respectively.
- Gastrointestinal bleeding, indicated by melena, hematemesis, and hematochezia, was the primary reason for endoscopy.
Conclusions:
- The COVID-19 pandemic had a substantial impact, leading to significant reductions in endoscopic procedures.
- Changes in patient behavior and presentation during the outbreak were observed.
- Further long-term studies are needed to understand the full effects on gastrointestinal endoscopy practices.
Background:
The surge of coronavirus disease 2019 (COVID-19) patients has markedly influenced the treatment policies of tertiary hospitals because of the need to protect medical staff and contain viral transmission, but the impact COVID-19 had on emergency gastrointestinal endoscopies has not been determined.
Aim:
To compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu, the worst-hit region in South Korea.
Methods:
This retrospective cohort study was conducted on patients aged ≥ 18 years that underwent endoscopy from February 18 to March 28, 2020, at a tertiary hospital in Daegu. Demographics, laboratory findings, types and causes of emergency endoscopies, and endoscopic reports were reviewed and compared with those obtained for the same period in 2018 and 2019.
Results:
From February 18 to March 28, a total of 366 emergent endoscopic procedures were performed: Upper endoscopy (170, 50.6%), endoscopic retrograde cholangiopancreatography (113, 33.6%), and colonoscopy with sigmoidoscopy (53, 15.8%). The numbers of procedures performed in 2018 and 2019 dropped by 48.8% and 54.8%, respectively, compared with those in 2020. During the COVID-19 outbreak, the main indications for endoscopy were melena (36.7%), hematemesis (30.6%), and hematochezia (10.2%). Of the endoscopic abnormalities detected, gastrointestinal bleeding was the most common: 39 cases in 2018, 51 in 2019, and 35 in 2020.
Conclusion:
The impact of COVID-19 is substantial and caused dramatic reductions in endoscopic procedures and changes in patient behaviors. Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in the endoscopy field.
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