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. 2021 Jun 1;12(6):e00365.
doi: 10.14309/ctg.0000000000000365.

Real-World Data on the Impact of COVID-19 on Endoscopic Procedural Delays

Rachel B Issaka  1   2 , Lauren D Feld  2 , Jason Kao  1   3 , Erin Hegarty  4 , Brandon Snailer  2 , Gorav Kalra  2 , Yutaka Tomizawa  2 , Lisa Strate  2
Affiliations

Real-World Data on the Impact of COVID-19 on Endoscopic Procedural Delays

Rachel B Issaka et al. Clin Transl Gastroenterol. .

Abstract

Introduction: The initial surge of the coronavirus disease 2019 (COVID-19) pandemic prompted national recommendations to delay nonurgent endoscopic procedures. The objective of this study was to provide real-world data on the impact of COVID-19 on endoscopic procedures in a safety-net healthcare system and cancer center affiliated with a tertiary academic center.

Methods: This retrospective cohort study used a combination of electronic health record data and a prospective data tool created to track endoscopy procedures throughout COVID-19 to describe patient and procedural characteristics of endoscopic procedures delayed during the initial COVID-19 surge.

Results: Of the 480 patients identified, the median age was 57 years (interquartile range 46-66), 55% (n = 262) were male, and 59% self-identified as white. Colonoscopy was the most common type of delayed procedure (49%), followed by combined esophagogastroduodenoscopy (EGD) and colonoscopy (22%), and EGD alone (20%). Colorectal cancer screening was the most common indication for delayed colonoscopy (35%), and evaluation of suspected bleeding (30%) was the most common indication for delayed combined EGD and colonoscopy. To date, 46% (223/480) of delayed cases have been completed with 12 colorectal, pancreatic, and stomach cancers diagnosed. Sociodemographic factors, procedure type, and sedation type were not significantly associated with endoscopy completion. The median time to endoscopy after delayed procedure was 88 days (interquartile range 63-119) with no differences by procedure type.

Discussion: To minimize potential losses to follow-up, delayed, or missed diagnoses and to reduce progression of gastrointestinal diseases, all efforts should be used to ensure follow-up in those whose endoscopic procedures were delayed because of COVID-19.

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Conflict of interest statement

Guarantor of the article: Rachel B. Issaka, MD, MAS.

Specific author contributions: Study concept and design: R.B.I., L.D.F., G.K., Y.T., and L.S. Acquisition, analysis, and interpretation of data: R.B.I., L.D.F., J.K., E.H., B.S., and G.K. Drafting of the article: R.B.I. and L.D.F. Critical revision of the article for important intellectual content: All authors. Approval of the final article: All authors.

Financial support: R.B.I. receives funding from National Institutes of Health/National Cancer Institute award number K08 CA241296. Role of the Funder/Sponsor: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication.

Potential competing interests: None reported.

Ethics approval: This study was reviewed and approved by our Institutional Review Board. As the study was deemed to be of minimal risk, a waiver of written informed consent was granted.

References

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