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. 2021 May 7;21(1):205.
doi: 10.1186/s12876-021-01796-4.

The role of endoscopy and findings in COVID-19 patients, an early North American Cohort

Gabriela Kuftinec  1   2 , B Joseph Elmunzer  3 , Sunil Amin  4   5 ; North American Alliance for the Study of Digestive Manifestations of Covid-19
Collaborators, Affiliations

The role of endoscopy and findings in COVID-19 patients, an early North American Cohort

Gabriela Kuftinec et al. BMC Gastroenterol. .

Abstract

Background and aims: Gastrointestinal manifestations in patients with COVID-19 are common but the role of endoscopy in this patient population remains unclear. We investigated the need for endoscopic procedures, their findings, and impact on patient care in a systematic and geographically diverse sample of patients hospitalized with COVID-19.

Methods: As part of the North American Alliance for the Study of Digestive Manifestations of COVID-19, we identified consecutive patients hospitalized with COVID-19 at 36 medical centers in the USA and Canada. We performed a secondary analysis of patients who underwent endoscopy, collecting information on endoscopic indications, findings, interventions, staffing, procedure location, anesthesia utilization, and adverse events.

Results: Data were collected on 1992 patients; 24 (1.2%) underwent 27 endoscopic procedures (18 upper endoscopies, 7 colonoscopies, 2 endoscopic retrograde cholangiopancreatographies). The most common indications were: gastrointestinal bleeding (13) and enteral access (6). The most common findings were erosive or inflammatory changes. Ten patients underwent an endoscopic intervention for hemostatic therapy (2), enteral access (6), or biliary obstruction (2). Half of cases employed anesthesiology support; no sedation-related adverse events were reported. One-third of cases were performed in the intensive care setting and one quarter in the endoscopy unit.

Conclusions: In this large, systematic, geographically diverse cohort of patients hospitalized with COVID-19 in North America, very few patients underwent endoscopy despite a high prevalence of gastrointestinal manifestations. Almost all endoscopic findings and interventions were thought related to critical illness rather than direct viral injury. This systematic assessment of endoscopic necessity and outcomes may help guide resource allocation in the event of ongoing and future surges.

Keywords: Endoscopy; Enteral access; GI bleeding; SARS-CoV-2; Viral Injury.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Procedure location used for endoscopic procedure
Fig. 2
Fig. 2
Procedure staffing by staff type
See this image and copyright information in PMC

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