Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2021; 9(15): 3576-3585
Published online May 26, 2021. doi: 10.12998/wjcc.v9.i15.3576
Changes in endoscopic patterns before and during COVID-19 outbreak: Experience at a single tertiary center in Korean
Kook Hyun Kim, Sung Bum Kim, Tae Nyeun Kim
Kook Hyun Kim, Sung Bum Kim, Tae Nyeun Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
Author contributions: Kim KH designed the research and wrote the paper; Kim SB provided the clinical advice and contributed to analysis; Kim TN supervised the research and reviewed manuscript.
Supported by The 2020 Yeungnam University Medical Center COVID-19 Research Grant.
Institutional review board statement: Written informed consent was waived due to the retrospective nature of the study, which was approved by the Institutional Review Board of Yeungnam University Medical Center.
Informed consent statement: Written informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kook Hyun Kim, MD, Associate Professor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170, Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. kimkh@yu.ac.kr
Received: January 4, 2021
Peer-review started: January 4, 2021
First decision: January 23, 2021
Revised: January 28, 2021
Accepted: April 8, 2021
Article in press: April 8, 2021
Published online: May 26, 2021
Abstract
BACKGROUND

The surge of coronavirus disease 2019 (COVID-19) patients has markedly influenced the treatment policies of tertiary hospitals because of the need to protect medical staff and contain viral transmission, but the impact COVID-19 had on emergency gastrointestinal endoscopies has not been determined.

AIM

To compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu, the worst-hit region in South Korea.

METHODS

This retrospective cohort study was conducted on patients aged ≥ 18 years that underwent endoscopy from February 18 to March 28, 2020, at a tertiary hospital in Daegu. Demographics, laboratory findings, types and causes of emergency endoscopies, and endoscopic reports were reviewed and compared with those obtained for the same period in 2018 and 2019.

RESULTS

From February 18 to March 28, a total of 366 emergent endoscopic procedures were performed: Upper endoscopy (170, 50.6%), endoscopic retrograde cholangiopancreatography (113, 33.6%), and colonoscopy with sigmoidoscopy (53, 15.8%). The numbers of procedures performed in 2018 and 2019 dropped by 48.8% and 54.8%, respectively, compared with those in 2020. During the COVID-19 outbreak, the main indications for endoscopy were melena (36.7%), hematemesis (30.6%), and hematochezia (10.2%). Of the endoscopic abnormalities detected, gastrointestinal bleeding was the most common: 39 cases in 2018, 51 in 2019, and 35 in 2020.

CONCLUSION

The impact of COVID-19 is substantial and caused dramatic reductions in endoscopic procedures and changes in patient behaviors. Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in the endoscopy field.

Keywords: COVID-19, Coronavirus, Endoscopy, Emergency endoscopy

Core Tip: This is the first East Asian report to be issued on the impacts of coronavirus disease 2019 (COVID-19) on emergent endoscopic activities and outcomes. This study demonstrated significant reductions in endoscopic procedures and changes in patient behaviors during the specific period (February 18 to March 28, 2020), from the start of the outbreak to the plateau of its exponential curve, in Daegu (South Korea), the worst-hit city, during the COVID-19 outbreak. We compared the changes in the numbers of endoscopic modalities and analyzed the causes and clinical outcomes of emergency endoscopies performed before (2018, 2019) and during the COVID-19 outbreak.