Impact of the COVID-19 pandemic in the time to endoscopy in patients with upper gastrointestinal bleeding

Abstract

Introduction: During the COVID-19 pandemic, endoscopic procedures are associated with a high risk of SARS-CoV-2 infection. However, in cases of upper gastrointestinal bleeding (UGIB), priority should be given to an early endoscopy. Objective: The main objective was to compare the time since arrival at the hospital and the performance of the endoscopy between both groups. Materials and methods: We performed a retrospective study. Data contains information of patients who attended to the hospital with UGIB and underwent an endoscopy between October 19th, 2019 and June 6th, 2020. Patients were divided into 2 phases: pre-pandemic and pandemic. The time between arrival at the hospital and the performance of the endoscopy in both phases were compared as well as other indicators such hospital stay and in-hospital mortality. Results: With information from 219 patients, the median age was 69 years. 154 and 65 endoscopies were performed in pre-pandemic and pandemic phase, respectively. The time between arrival at the hospital and the performance of the endoscopy was significantly longer duringthe pandemic (10.00 vs. 13.08 hours, p-value = 0.019). Nevertheless, there were no significant differences in hospital stay or mortality. Conclusion: The management of patients with UGIB during the COVID-19 pandemic is complex and requires the application of clinical judgment to decide the best timing to perform an endoscopy without affecting patient care.

The Prevalence of Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

“…In the era of COVID-19, therefore, a decrease in endoscopies was observed [ 81 , 82 ]. However, in some cases it was deemed necessary to perform endoscopy to manage GIB.…”

Factores asociados a necesidad de tratamiento endoscópico en pacientes con COVID-19 y hemorragia gastrointestinal alta

“…La HTDA se considera una urgencia médica y justifica la realización de una endoscopia superior, incluyendo pacientes con COVID-19 [12][13][14] . Actualmente no existe literatura de nuestro medio que reporte los hallazgos endoscópicos en pacientes con HTDA y COVID-19 ni la frecuencia de terapia endoscópica, por lo que el objetivo del presente estudio fue describir las alteraciones endoscópicas en pacientes hospitalizados con diagnóstico de COVID-19 en quienes se realizó endoscopia superior por HTDA, así como los factores asociados a necesidad de tratamiento endoscópico.…”