Analysis of patients attitude to undergo urgent endoscopic procedures during COVID-19 outbreak in Italy

Abstract

We conducted a survey to investigate to what extent the fear of COVID-19 has influenced the patients decision to undergo or to cancel endoscopic procedures. We collected data from 847 patients from 13 centres. The main indication for endoscopy was anemia, followed by pain and unexplained weight loss. The percentage of not presenters progressively increased throughout the three weeks of study, from 15.1% at the beginning to 48.2% at the end. 37 (34.2%) upper GI endoscopies and 112 (56.3 %) colonoscopies showed an organic cause explaining the symptoms presented by the patients, respectively; 5 cases of gastric cancer (4.6%) and 16 cases of colorectal cancer (CRC) (6.0%), respectively, were detected; during the second week the percentage of organic diseases found at upper endoscopy was 19 (33.3%) with 5 cancer (8.7%), and 61 (49.1% ) at colonoscopy, with 2 CRC (1.6%); finally, during the third week the corresponding figures were 19 (48.7%) for upper GI examinations, with 3 gastric cancers (7.7%), and 43 (60.5%) with 4 (6.5%) CRC cases found.We conclude that patients weighted the fear of having a clinically relevant disease with the fear of becoming infected by coronavirus, and a relevant percentage of them (29.4%) decided not to attend the endoscopy suites at the scheduled date.

Adoption of Multi-society Guidelines Facilitates Value-Based Reduction in Screening and Surveillance Colonoscopy Volume During COVID-19 Pandemic

“…These patients should be brought in for CRC screening prior to considering those patients who were scheduled early. Furthermore, as a significant proportion of patients may be unwilling to schedule a needed colonoscopy during the pandemic, resources to encourage colonoscopy adherence should only be allocated to those patients who are actually due for colonoscopy based on the newest guidelines [14].…”

Multicentre prospective study of COVID-19 transmission following outpatient GI endoscopy in the UK

“…Significant patient anxiety regarding the potential for contracting COVID-19 infection also exists and this has also been demonstrated to influence the ability to provide effective diagnostic services. 12 We therefore sought to study prospectively the number of patient infections following GI endoscopy from multiple centres across the UK through the peak, deceleration and early recovery phases of the pandemic. Taking into account the complexities of infection control, aerosols, infectivity and abrogation of risk by PPE, it was felt that the ultimate determinant of risk would be whether any COVID-19 cases were actually detected after endoscopy (in either patients or staff).…”

Improvement in appropriateness and diagnostic yield of fast-track endoscopy during the COVID-19 pandemic in Northern Italy

“…Rex et al have reported that during the pandemic 44% of patients scheduled for endoscopy were very or somewhat concerned about acquiring infection, while 25% were quite unsure or not willing at all to undergo endoscopy [11]. In an emerging epidemic, human behavioral changes are driven by risk perceptions [7], [12], [13] and this is also related to the psychological status of patients, the self-perception of vulnerability and the perceived severity of symptoms. Our findings demonstrate that patients attending endoscopy during the pandemic were younger than in 2019, a circumstance that can be explained with the perceived higher risk of developing more severe infection in elderly.…”