Impact of the COVID-19 pandemic on endoscopy practice in the Czech Republic – survey research

Česká verzia

Authors: Ilja Tachecí ¹ ; Urban O. ²; Lukáš M. ³; S. Rejchrt ¹ ; Bureš J. ¹; Falt P. ²; Vitek P. ⁴; Hrdlička L. ⁵; Douda L. ¹
Authors place of work: II. interní gastroenterologická klinika LF UK a FN Hradec Králové ¹; II. interní klinika – gastroenterologie a geriatrie LF UP a FN Olomouc ²; Klinické a výzkumné centrum pro střevní záněty ISCARE a. s., Praha ³; Interní oddělení, Nemocnice ve Frýdku-Místku, p. o. 5 ResTrial GastroEndo, Praha ⁴
Published in the journal: Gastroent Hepatol 2020; 74(3): 195-203
Category: Digestive Endoscopy: Original Article
doi: https://doi.org/10.14735/amgh2020195

Summary

Introduction: The SARS-CoV-2 pandemic caused significant changes in gastrointestinal endoscopy practice in the Czech Republic during March and April 2020. The Czech Society of Gastroenterology (CSG) developed statements and guidelines aimed at solving specific practical problems in this situation. On April 20, 2020, internet based survey was published (under the heading of the Czech Gastroenterology Study Group): Endoscopy in the SARS-CoV-2 pandemic.

Aim and methods: Aim of the survey was to obtain basic information on the SARS-CoV-2 infection in the field of digestive endoscopy in the Czech Republic, on the feasibility of measures recommended by the CSG and on problematic areas during the first phase of the pandemic. A set of 23 questions was created, covering the period between 1.3. and 20.4.2020. The links to the survey were sent to all CSG members (875 original e-mail addresses).

Results: Ninety questionnaires were evaluated. The survey involved 62 men (69%) and 28 women (31%) of whom 92% were certified gastroenterologists, 52% hospital staff and 48% physicians in private endoscopy practice. A total of 72 responses were obtained from endoscopy unit leaders. Eight respondents (9%) were in contact with an infected patient and only one endoscopist (1%) became ill during the monitored period. There were seven patients only who underwent acute endoscopy with a diagnosis of COVID-19. The endoscopic care plan for patients with COVID-19 was developed in 53% of all respondents and in 88% of units dedicated to endoscopy of at-risk patients. The CSG statements were a source of information and recommendations for a total of 63% of respondents (68% of COVID-19 dedicated endoscopy units). The majority of endoscopy units significantly reduced endoscopy activities during the monitored period (86%), mainly to acute and selected elective procedures. Complete discontinuation of practice was reported by 7% only. A significant problem was the lack of personal protective equipment (83% of units dedicated to endoscopy in COVID-19 positive patients) during the first phase of pandemic. The collection of epidemiological data (91%) and stratification of patients (77%) were generally the most frequently used measures, followed by the choice of personal protective equipment according to the degree of the risk. The possibilities of testing before digestive endoscopy (polymerase chain reaction of SARS-CoV-2 from nasopharyngeal swab) were significantly limited (not available for 57% of respondents).

Conclusion: The SARS-CoV-2 pandemic represents a new experience in the field of gastrointestinal endoscopy with the need to introduce a number of epidemiological and hygienic regulations. The statements of the Czech Society of Gastroenterology represented an important source of information and recommendations in this context. The data obtained from the survey enabled a critical evaluation of the pandemic impact in the Czech Republic and thus future creation of revised and realistic measures in digestive endoscopy too.

Keywords:

SARS-CoV-2 – COVID-19 – pandemic – gastrointestinal endoscopy – Czech Society of Gastroenterology

Zdroje

1. Lukáš M. Doporučení pro léčbu idiopatických střevních zánětů v době pandemie covid-19.Gastroent Hepatol 2020; 74 (2): 123–129. doi: 1014735/amgh2020123.

2. Tachecí I. Gastroenterologie a gastrointestinální endoskopie v podmínkách pandemie viru SARS-CoV-2. Gastroent Hepatol 2020; 74 (2): 163–164. doi: 1014735/amgh2020163.

3. Stanovisko ČGS k provádění digestivní endoskopie v podmínkách pandemie koronaviru – aktualizace 18.6.2020. [online]. Dostupné z: https: //www.cgs-cls.cz/stanovisko-cgs-k-provadeni-digestivni-endoskopie-v-podminkach-pandemie-koronavirem-troentero-logu-2/.

4. Repici A, Maselli R, Colombo M et al. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. [online]. Available from: https: //www.giejour-nal.org/article/S0016-5107 (20) 30245-5/abstract.

5. Guidance for resuming GI endoscopy and practice operations after the COVID-19 pandemic – update 28. 04. 2020. [online]. Available from: https: //www.asge.org/docs/default-source/default-document-library/asge-guidance-for-reopeningl_4-28-2020.pdf.

6. Endoscopy activity and COVID-19: BSG and JAG guidance – update 03.04.2020. [online]. Available from: https: //www.bsg.org.uk/covid-19-advice/endoscopy-activity-and-covid-19-bsg-and-jag-guidance/.

7. Gralnek IM, Hassan C, Beilenhoff U et al. ESGE and ESGENA position statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; 52 (6): 483–490. doi: 10.1055/a-1155-6229.

8. Sultan S, Lim JK, Altayar O et al. AGA institute rapid recommendations for gastrointestinal procedures during the COVID-19 pandemic. [online]. Available from: https: //www.gastrojournal.org/article/S0016-5085 (20) 30458-3/pdf.

9. Johns Hopkins University and Medicine. Coronavirus Resource Center. [online]. Available from: https: //coronavirus.jhu.edu/.

10. European Centre for Disease Prevention and Control. COVID-19 situation update for the EU/EEA and the UK, as of 19 June 2020. [online]. Available from: https: //www.ecdc.europa.eu/en/cases-2019-ncov-eueea.

11. Wolfel R, Corman VM, Guggemos W et al. Virological assessment of hospitalized patients with COVID-2019. Nature 2020; 581 (7809): 465–469. doi: 10.1038/s41586-020-2196-x.

12. British Society of Gastroenterology guidance on recommencing gastrointestinal endoscopy in the deceleration and early recovery phases of COVID-19 pandemic – update 03.06.2020. [on-line]. Available from: https: //www.bsg.org.uk/covid-19-advice/bsg-guidance-on-recommencing-gi-endoscopy-in-the-deceleration-early-recovery-phases-of-the-covid-19-pandemic/.

13. Postup testování osob na přítomnost koronaviru a pravidla pro nařízení a ukončení domácí karantény, domácí izolace a hospitalizace. [online]. Dostupné z: https: //koronavirus.mzcr.cz/postup-testovani-osob-na-pritomnost-koronaviru-a-pravidla-pro-narizeni-a-ukonceni-domaci-karanteny-domaci-izolace-a-hospitalizace.

14. Stanovisko KS-COVID k testování COVID-19bezpříznakových pacientů před přijetím k hospitalizaci, před léčebnými výkony a v souvislosti s překlady mezi poskytovateli zdravotní péče. [online]. Dostupné z: https: //koronavirus.mzcr.cz/wp-content/uploads/2020/06/KS-COVID-provadeni-PCR-hospitalizace-operace-29.5. 2020.pdf.