The Impact of COVID-19 on Gastrointestinal Motility Testing in Asia and Europe

Abstract

Background: The new coronavirus disease (COVID-19) has high infection and mortality rates, and has become a pandemic. The infection and mortality rates are lower in Asian countries than in European countries. This study aimed to conduct a survey on the effects of COVID-19 on the capacity to perform gastrointestinal motility tests in Asian countries compared with European countries.

Methods: We used the questionnaire previously established by our team for researchers in European countries. The correlation between the decreased rate of gastrointestinal motility and function tests, and the infection/mortality rates of COVID-19 and stringency of a government's interventions in each country was analysed and protective measures were assessed.

Results: In total, 58 gastroenterologists/motility experts in Asian countries responded to this survey. The infection/mortality rates of COVID-19 and Stringency Index had a significant impact on the testing capacity of oesophageal manometry and catheter-based pH monitoring. In European countries, most facilities used filtering facepiece 2/3 (FFP2/3) masks during oesophageal motility studies. Meanwhile, in Asian countries, most facilities used surgical masks.

Conclusion: The total infection and mortality rates of COVID-19 can affect the rate of gastrointestinal motility testing and the type of protective equipment that must be used.

Keywords: COVID-19; SARS-CoV-2; anorectal manometry; breath tests; catheter-based pH-monitoring; infection prevention; motility disorders of the gastrointestinal tract; oesophageal manometry; wireless pH-monitoring (Bravo®).

Figure 1

The relationships between median reduction rates of capacity for oesophageal manometry, total infection rate (A)/mortality rate (B) for COVID-19 and Stringency Index (C) in Asian and European countries, are described. There was a significant trend between the infection rates of COVID-19, the Stringency Index and the median reduction rates of oesophageal manometry.

Figure 2

The relationships between median reduction rates of capacity for catheter-based pH monitoring, total infection rate (A)/mortality rate (B) for COVID-19 and Stringency Index (C) in Asian and European countries, are described. There was a significant trend between the infection rates and mortality rates of COVID-19, the Stringency Index and the median reduction rates of catheter-based pH monitoring.

Figure 3

The relationships between median reduction rates of capacity for wireless pH testing (Bravo^®), total infection rate (A)/mortality rate (B) for COVID-19 and Stringency Index (C) in Asian and European countries, are described. Almost all countries, except Taiwan, had completely discontinued this type of testing.

Figure 4

The relationships between median reduction rates of capacity for anorectal manometry, total infection rate (A)/mortality rate (B) for COVID-19 and Stringency Index (C) in Asian and European countries, are described. No significant trends were observed. Meanwhile, in Europe, anal manometry was stopped in countries with SARS-CoV-2 infection rates above 3000 per million people or with mortality rates above 200 per million people.

Figure 5

The relationships between median reduction rates of capacity for breath tests, total infection rate (A)/mortality rate (B) for COVID-19 and Stringency Index (C) in Asian and European countries, are described. No significant trends were observed in the relationships between the median reduction rates of breath tests, total infection rate/mortality rate of COVID-19 and Stringency Index.