Characteristics and Outcomes of Patients Undergoing Endoscopy During the COVID-19 Pandemic: A Multicenter Study from New
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ORIGINAL ARTICLE
Characteristics and Outcomes of Patients Undergoing Endoscopy During the COVID‑19 Pandemic: A Multicenter Study from New York City John W. Blackett1 · Nikhil A. Kumta2 · Rebekah E. Dixon2 · Yakira David2 · Satish Nagula2 · Christopher J. DiMaio2 · David Greenwald2 · Reem Z. Sharaiha3 · Kartik Sampath3 · David Carr‑Locke3 · Arcelia Guerson‑Gil4 · Sammy Ho4 · Benjamin Lebwohl1 · Reuben Garcia‑Carrasquillo1 · Anjana Rajan3 · Vasantham Annadurai1 · Tamas A. Gonda1 · Daniel E. Freedberg1 · Srihari Mahadev3 Received: 22 June 2020 / Accepted: 28 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the practice of endoscopy, but characteristics of COVID patients undergoing endoscopy have not been adequately described. Aims To compare findings, clinical outcomes, and patient characteristics of endoscopies performed during the pandemic in patients with and without COVID-19. Methods This was a retrospective multicenter study of adult endoscopies at six academic hospitals in New York between March 16 and April 30, 2020. Patient and procedure characteristics including age, sex, indication, findings, interventions, and outcomes were compared in patients testing positive, negative, or untested for COVID-19. Results Six hundred and five endoscopies were performed on 545 patients during the study period. There were 84 (13.9%), 255 (42.2%), and 266 (44.0%) procedures on COVID-positive, negative, and untested patients, respectively. COVID patients were more likely to undergo endoscopy for gastrointestinal bleeding or gastrostomy tube placement, and COVID patients with gastrointestinal bleeding more often required hemostatic interventions on multivariable logistic regression. COVID patients had increased length of stay, intensive care unit admission, and intubation rate. Twenty-seven of 521 patients (5.2%) with no or negative COVID testing prior to endoscopy later tested positive, a median of 13.5 days post-procedure. Conclusions Endoscopies in COVID patients were more likely to require interventions, due either to more severe illness or a higher threshold to perform endoscopy. A significant number of patients endoscoped without testing were subsequently found to be COVID-positive. Gastroenterologists in areas affected by the pandemic must adapt to changing patterns of endoscopy practice and ensure pre-endoscopy COVID testing. Keywords COVID-19 · Coronavirus · Endoscopy · Gastrointestinal bleeding
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10620-020-06593-9) contains supplementary material, which is available to authorized users. * Srihari Mahadev [email protected] 1
Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY, USA
Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
2
The novel coronavirus pandemic brought routine endos
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