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
ARTICLE HIGHLIGHTS
Research background

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

Research motivation

Endoscopy involves direct contact with patients’ body fluid, oropharyngeal mucosa and fecal fluid. Furthermore, endoscopic procedures can act as covert vehicles of transmission due to aerosol formation during endoscopic manipulations, and it is known that severe acute respiratory syndrome coronavirus-2 can survive in the gastrointestinal tract for more than 2 wk.

Research objectives

This study was undertaken to compare endoscopic activities and analyze the clinical outcomes of emergency endoscopies performed before and during the COVID-19 outbreak in Daegu City, the epicenter of the first serious outbreak in South Korea.

Research methods

The medical records of patients that underwent endoscopy from February 18 to March 28, 2020, at a tertiary teaching hospital were retrospectively evaluated. Demographic data, laboratory data, chief complaints, types of endoscopies, causes of emergent endoscopies, and endoscopic reports were reviewed during the above-mentioned period and for the same periods during 2018 and 2019.

Research results

The number of emergent endoscopic procedures performed in 2020 was 48.8% and 54.8% lower than in 2018 and 2019, respectively. During the COVID-19 outbreak, the main indications for endoscopy were melena (36.7%), hematemesis (30.6%), and hematochezia (10.2%), and gastrointestinal bleeding was the most common endoscopic abnormalities detected (39 cases in 2018, 51 in 2019, and 35 in 2020).

Research conclusions

The COVID-19 outbreak resulted in significant reductions in endoscopic procedures and changes in patient behaviors.

Research perspectives

Long-term follow-up studies are required to determine the effects of COVID-19 induced changes in patient behaviors, endoscopy types, missed malignancies, disease progressions, and patient outcomes.