Effect of the SARS-CoV-2 Pandemic on Gastrointestinal Endoscopy Procedures: Experience of a Tertiary Care Center From Eastern India.

Abstract

Background To contain the spread of infection and reduce the burden on healthcare infrastructure, many countries globally adopted a lockdown strategy during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Hospitals were converted to dedicated coronavirus disease 2019 (COVID-19) centers, and non-COVID-19 patients were intervened on a triage basis. During this time, only emergency procedures were performed. The impact of this lockdown strategy during the first wave of the SARS-CoV-2 pandemic on various gastrointestinal endoscopy interventions remains unknown. Methodology In thisretrospective, observational study conducted in theDepartment of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar fromMarch 25to September 30, 2020, data related to clinical profile, indication, and endoscopic interventionsperformed in reverse transcriptase-polymerase chain reaction (RT-PCR)-negativepatients with the use of personal protective kits were analyzed and compared with the historical controls. Results A total of 2,282 patients were admitted and 422 endoscopic procedures were performed during the six-month study period with an intervention rate of 18.49%. The most common procedure was upper gastrointestinal endoscopy (228, 58.13%), followed by endoscopic retrograde cholangiopancreatography (ERCP) (88, 22.50%). Chronic liver disease (CLD) (144 patients) followed by malignancy (111 patients) were the most common diagnosis. During the first phase of the lockdown (March to May), only 52 procedures were performed (52 vs. 506). None of the patients underwent endoscopic ultrasound. In 2019, 4,501 patients were admitted and 1,224 procedures were performed with an intervention rate of 27.19 (p < 0.0001). None of the staff of the Department of Gastroenterology developed symptomatic SARS-CoV-2 infection during this period. Conclusions There was a significant drop in endoscopic procedures during the lockdown and most of the esophagoduodenoscopy procedures were done for CLD and ERCP for biliary tract malignancy. Endoscopic procedures done on RT-PCR for COVID-19-negative patients were safe using personal protective kits.