BACKGROUND
Coronavirus disease 2019 (COVID-19) significantly affected endoscopy
practice, as gastrointestinal endoscopy is considered a risky procedure
for transmission of infection to patients and personnel of endoscopy
units (PEU).
AIM
To assess the impact of COVID-19 on endoscopy during the first European
lockdown (March-May 2020).
METHODS
Patients undergoing endoscopy in nine endoscopy units across six
European countries during the period of the first European lockdown for
COVID-19 (March-May 2020) were included. Prior to the endoscopy
procedure, participants were stratified as low- or high- risk for
potential COVID-19 infection according to the European Society of
Gastrointestinal Endoscopy (ESGE) and the European Society of
Gastroenterology and Endoscopy Nurses and Associates (ESGENA) joint
statement, and contacted 7-14 d later to assess COVID-19 infection
status. PEU were questioned regarding COVID-19 symptoms and/or infection
via questionnaire, while information regarding hospitalizations,
intensive care unit-admissions and COVID-19-related deaths were
collected. The number of weekly endoscopies at each center during the
lockdown period was also recorded.
RESULTS
A total of 1267 endoscopies were performed in 1222 individuals across
nine European endoscopy departments in six countries. Eighty-seven (7%)
were excluded because of initial positive testing. Of the 1135
pre-endoscopy low risk or polymerase chain reaction negative for
COVID-19, 254 (22.4%) were tested post endoscopy and 8 were eventually
found positive, resulting in an infection rate of 0.7% [(95%CI:
0.2-0.12]. The majority (6 of the 8 patients, 75%) had undergone
esophagogastroduodenoscopy. Of the 163 PEU, 5 [3%; (95%CI: 0.4-5.7)]
tested positive during the study period. A decrease of 68.7% (95%CI:
64.8-72.7) in the number of weekly endoscopies was recorded in all
centers after March 2020. All centers implemented appropriate personal
protective measures (PPM) from the initial phases of the lockdown.
CONCLUSION
COVID-19 transmission in endoscopy units is highly unlikely in a
lockdown setting, provided endoscopies are restricted to emergency cases
and PPM are implemented.
