The impact of personal protective equipment on quality measures of upper gastrointestinal endoscopy

Esophagogastroduodenoscopy (EGD) is a frequently performed endoscopic procedure that is critical for detecting early neoplastic lesions in the gastrointestinal tract. During the COVID-19 pandemic, operators were forced to use personal protective equipment due to the risk of virus transmission during gastroscopy.

This study aimed to determine the impact of the sanitary regime on the quality indicators of EGD.

Data from 12,322 patients who underwent diagnostic EGD between January 2019 and December 2021 performed in three endoscopy units were analysed. The evaluated parameters were as follows: composite detection rate (CDR), endoscopist biopsy rate (EBR), and upper gastrointestinal neoplasm detection (UGN).

Of the patients, 6918 were female (56%), with a mean age of 58 years (IQR 24). Compared to the pre-pandemic period, during the pandemic (from 03.2020) there was an increase in UGN (3.1% vs. 4.6%, OR = 1.53, 95% CI: 1.26-1.86), CDR (26.0% vs. 31.1%, OR = 1.30, 95% CI: 1.20-1.41), and EBR (66.8% vs. 77.2%, OR = 1.69, 95% CI: 1.56-1.83). In the multivariate regression analysis, age (OR = 1.02, 95% CI: 1.02-1.03), male sex (OR = 1.5, 95% CI: 1.24-1.81), presence of alarm symptoms (OR = 3.93, 95% CI: 3.18-4.86), EGD performed during the COVID-19 pandemic (OR = 1.53, 95% CI: 1.24-1.89), and endoscopy performed in the centre K (OR = 3.01, 95% CI: 2.14-4.22) were related with UGN.

Despite the use of personal protective equipment, gastroscopy quality indicators and cancer detection rates increased during the COVID-19 pandemic.