LIKELIHOOD OF DIAGNOSIS OF EOSINOPHILIC ESOPHAGITIS VIA ENDOSCOPY IN DYSPHAGIA DURING THE COVID-19 PANDEMIC

Abstract

<h3>Introduction</h3> The COVID-19 pandemic posed restrictions to many standard practices. Dysphagia is a common presentation of eosinophilic esophagitis (EoE) in adults. The gold standard method for diagnosis of EoE remains biopsy via esophagogastroduodenoscopy (EGD). We hypothesized that diagnosis of EoE decreased during the pandemic. In this study, we sought to investigate whether the COVID-19 pandemic influenced the likelihood of EGD for diagnosis of EoE in patients with dysphagia. <h3>Methods</h3> In this retrospective cohort study, we used the TriNetX Research Network to identify adult patients presenting with dysphagia to emergency department (ED) during the year of and the year preceding the pandemic. Patients with prior EoE diagnosis were excluded. Using 1:1 propensity score matching, the two cohorts were balanced for demographics, GERD diagnosis, body mass index, H2 blockers and proton pump inhibitors use, anemia, smoking, and alcohol use. The 30-day likelihood of EGD, EoE and GERD diagnosis were contrasted. <h3>Results</h3> We identified 23,759 adult patients presenting to the ED with dysphagia in 2020 during the pandemic, and 20,398 patients in 2019 (the preceding year). After propensity score matching, 19,196 patients remained in each cohort. During the 30-day follow-up period, more patients received EGD during the pandemic versus the pre-pandemic period (11% versus 10.2%; P=0.020). The 30-day likelihood of <i>de novo</i> EoE diagnosis was not different (0.8% versus 0.8%; P=0.95), but more patients received GERD diagnosis during the pandemic as compared to pre-pandemic (33% versus 31%; P<0.001). <h3>Conclusion</h3> Our results revealed that the COVID-19 pandemic did not significantly impact the likelihood of EoE diagnosis.