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. 2022;17(4):301-309.
doi: 10.5114/pg.2021.111392. Epub 2021 Dec 8.

The impact of COVID-19 on elective and urgent digestive endoscopic procedures: a report on a year of pandemic in a gastroenterology centre in Italy

Giovanna Del Vecchio Blanco  1 , Edoardo Troncone  1 , Enrico Grasso  1 , Elena De Cristofaro  1 , Giorgia Sena  1 , Pasquale De Vico  2 , Mario Dauri  2 , Giovanni Monteleone  1 , Omero Alessandro Paoluzi  1
Affiliations

The impact of COVID-19 on elective and urgent digestive endoscopic procedures: a report on a year of pandemic in a gastroenterology centre in Italy

Giovanna Del Vecchio Blanco et al. Prz Gastroenterol. 2022.

Abstract

Introduction: The COVID-19 pandemic (COVID-19) affected digestive endoscopic activity worldwide. Resumption and maintenance of elective endoscopic activity are crucial to containing the impact of COVID-19 on mortality and prognosis of gastrointestinal disorders, primarily cancers.

Aim: To assess the impact of COVID-19 during and after the lockdown period on endoscopic activity.

Material and methods: The endoscopic activity undertaken during the COVID-19-related lockdown (March 2020-May 2020) and in the post-lockdown period (June 2020-March 2021) was compared with that in the corresponding periods of the year before COVID-19 in a gastroenterology centre in Italy.

Results: During the lockdown period, there was a reduction in esophagogastroduodenoscopy (EGD), colonoscopy (CSPY), endoscopic ultrasound (EUS), and endoscopic-retrograde cholangiopancreatography (ERCP) of 75.8%, 74.8%, 60%, and 42%, respectively, compared with the corresponding period of the year before COVID-19. During the post-lockdown period to date, EGD, CSPY, EUS, and ERCP increased as compared to the lockdown period (30.6%, 50.6%, 33.6%, and 65.4%, respectively), but only ERCP showed a full recovery when compared with the corresponding period of the year before COVID-19.

Conclusions: Endoscopic activity decreased significantly during the COVID-19 lockdown, and only ERCP had a full recovery in the post-lockdown period. The pandemic-related limitations and the backlog of endoscopic procedures represent important reasons for the increased risk or delayed diagnosis of GI cancers.

Keywords: COVID-19; SARS-CoV-2; colonoscopy; endoscopic ultrasound; endoscopic-retrograde-cholangio-pancreatography; esophagogastroduodenoscopy; fine-needle aspiration.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Endoscopic procedures carried out during COVID-19 pandemic-related lockdown (23 March 2020–18 May 2020) and in the corresponding period of the year before COVID-19. During lockdown, there was a marked decrease in the endoscopic activity, more pronounced in EGD and CSPY CSPY – colonoscopy, EGD – esophago-gastro-duodenoscopy, ERCP – endoscopic-retrograde cholangiopancreatography, EUS – endoscopic ultrasound.
Figure 2
Figure 2
Elective endoscopy in the COVID-19-related post-lockdown period (June 2020–March 2021) compared with the corresponding period of the year before COVID-19. Trends in the number of esophagogastroduodenoscopy (A) and colonoscopy (B) showed a gradual, but slight, recovery in comparison to the corresponding period in the year before COVID-19 CSPY – colonoscopy, EGD – esophago-gastro-duodenoscopy.
Figure 3
Figure 3
Endoscopic-retrograde cholangiopancreatography and endoscopic ultrasound undertaken in the COVID-19-related post-lockdown period (June 2020–March 2021) compared with the corresponding period of the year before COVID-19. Endoscopic-retrograde cholangiopancreatography had a significant rebound from June to October, exceeding the number of those performed in the same months in the pre-COVID-19 year (A), while endoscopic ultrasound had a slight but not significant recovery (B) ERCP – endoscopic-retrograde cholangiopancreatography, EUS – endoscopic ultrasound.
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