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COVID-19 AND DIGESTIVE ENDOSCOPY: EMERGENCY ENDOSCOPIC PROCEDURES AND RISK FACTORS FOR UPPER GASTROINTESTINAL
Leticia Rosevics1, Bruna Streppel Fossati1, Sandra Teixeira1
1Universidade Federal do Paraná, Hospital de Clínicas, Curitiba, PR, Brasil.
Insights
Urgent endoscopic procedures increased during the COVID-19 pandemic. For patients hospitalized with COVID-19, intensive care unit (ICU) admission and mechanical ventilation are risk factors for upper gastrointestinal bleeding (UGIB).
Area of Science:
- Gastroenterology
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic significantly impacted healthcare services globally, including digestive endoscopy.
- Disruptions necessitated adaptations in managing urgent and emergency endoscopic procedures.
Purpose of the Study:
- To quantify changes in urgent/emergency endoscopic procedures during the COVID-19 pandemic in a Brazilian hospital.
- To compare procedure rates with the pre-pandemic period (2019 vs. 2020).
- To identify risk factors for upper gastrointestinal bleeding (UGIB) in COVID-19 patients undergoing endoscopy.
Main Methods:
- Retrospective, cross-sectional, observational study at a single center.
- Analysis of urgent/emergency endoscopic procedures in adult patients from March to August 2019 and 2020.
- Evaluation of COVID-19 patients (RT-PCR confirmed) for demographics, comorbidities, ICU stay, and mechanical ventilation, correlating with UGIB.
Main Results:
- A total of 130 urgent/emergency endoscopic procedures were performed in 2020, compared to 97 in 2019, indicating an increase.
- Sixteen COVID-19 patients underwent urgent/emergency endoscopy, with 10 cases of UGIB.
- Need for ICU admission and/or mechanical ventilation emerged as statistically significant risk factors for UGIB in COVID-19 patients.
Conclusions:
- The study confirms an increase in urgent/emergency endoscopic procedures during the COVID-19 pandemic at the studied institution.
- COVID-19 patients requiring ICU care or mechanical ventilation face a heightened risk of upper gastrointestinal bleeding.
Background:
The COVID-19 pandemic has changed digestive endoscopy services around the world.
Objective:
This study aimed to measure the number of urgent/emergency endoscopic procedures performed in a Brazilian hospital, comparing it to the same period in the previous year, and to identify risk factors in COVID-19 patients undergoing endoscopic procedures for upper gastrointestinal bleeding (UGIB).
Methods:
This was a retrospective, cross-sectional, observational, single-center study. The study evaluated urgent/emergency endoscopic procedures performed on adult patients from March to August in 2019 and 2020. The COVID-19 patients included were diagnosed using RT-PCR, aged over 18 years with complete medical record information. The variables evaluated were age, sex, comorbidities, length of stay, D-dimer, need for intensive care unit (ICU) and mechanical ventilation. Student's t-test for independent samples or the non-parametric Mann-Whitney test was used to compare quantitative variables. Categorical variables were analyzed using Fisher's exact test. A P-value <0.05 indicated statistical significance.
Results:
A total of 130 urgent/emergency endoscopic procedures were performed in 2020 and 97 in 2019. During the study period, 631 patients were hospitalized due to COVID-19, of whom 16 underwent urgent/emergency endoscopic procedures, 10 (1.6%) due to UGIB. Of the variables analyzed, the need for ICU and/or mechanical ventilation during hospitalization was statistically significant as a risk factor for UGIB.
Conclusion:
This study showed increased urgent/emergency endoscopic procedures during the pandemic at the study site. Among the patients hospitalized with the novel coronavirus, there is a higher risk for UGIB in those needing ICU and/or mechanical ventilation.
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