Effect of the SARS-CoV2 Pandemic on Endoscopy Provision – The Impact of Compliance with National Guidance

ABSTRACT

Objective: There are limited data on the impact of the pandemic upon endoscopy service provision and quality indicators.

Methods: Analysis of number and type of procedure, in-room time (minutes), key performance indicators, and list utilization was performed over three periods; pre-lockdown, lockdown, and early recovery and compared with the previous year.

Results: Endoscopy activity reduced to 13.3% of the same period in 2019 with the largest drops in colonoscopy and flexible sigmoidoscopy numbers. In-room time increased significantly for gastroscopy (35 vs. 24, p < 0.0001), flexible sigmoidoscopy (20 vs. 15, p < 0.0001), endoscopic ultrasound (40 vs. 32, p = 0.0009), and ERCP (59 vs. 45, p = 0.0041). There was no increase for colonoscopy (35 vs 35, p = 0.129). There was a significant reduction in in-room time for gastroscopy alone (44.5 vs. 30.0, p = 0.0002) over the study period. There was no significant difference in cecal intubation rate, polyp detection rate, or biliary cannulation rate compared to the previous year.

Conclusions: The pandemic has profoundly reduced the number of endoscopies performed with some recovery. In-room time has significantly increased but with the preservation of key performance indicators. List utilization remains a significant problem and resources need to be adequately aligned to improve this.

KEYWORDS:

• SARS-CoV-2
• endoscopy
• timing
• key performance indicators
• guidelines

Author contributions

JSL and DLN conceived and designed the study, JSL, BA, CD, MKN, KWO, and DLN analyzed and interpreted the data, JSL drafted the paper, and JSL, BA, CD, MKN, KWO, and DLN revised the paper critically for intellectual content. JSL, BA, CD, MKN, KWO, and DLN approved the final version and agree to be accountable for all aspects of the work.

Declaration of interest

All of the authors have no conflict of interest to declare.

Abbreviations

ERCP – Endoscopic Retrograde Cholangiopancreatography, COVID19 – Coronavirus disease 19, NED – National Endoscopy Database, KPI – Key Performance Indicators, EUS – Endoscopic Ultrasound, NHS – National Health Service, ADAM – Advanced Digitising And More, OGD – OesophagoGastroDuodenoscopy, UK – United Kingdom.

Declaration of interest

‘The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.’