Effect of COVID-19 on gastrointestinal endoscopy practice: a systematic review

Figures & data

Table 1. Statements from different endoscopy societies during COVID-19 pandemic as for March 2020.

Asian Pacific Society for Digestive Endoscopy

Defer elective endoscopic procedures, while urgent endoscopies should be performed by strategically assigned staff to minimize concomitant exposure.

European Society of Gastrointestinal Endoscopy (ESGE)

Defer elective endoscopic procedures. The patient should be assessed for high versus low risk of GIT, while urgent endoscopies should be performed by strategically assigned staff to minimize concomitant exposure.

World Endoscopy Organization (WEO)

Postpone non-urgent examinations. Upper GI bleeding, foreign body/obstruction; acute cholangitis are not deferred.

American Society for Gastrointestinal Endoscopy (ASGE)

Postpone non-urgent examinations. Upper GI bleeding, foreign body/obstruction; acute cholangitis, care of cancer not postponed.

American College of Gastroenterology (ACG);

Postpone non-urgent examinations. Upper GI bleeding, foreign body/obstruction; acute cholangitis, care of cancer, prosthetic removals are not postponed.

Sociedad Interamericana de Endoscopia Digestiva (SIED); Canada/Central and Latin America

Postpone non-urgent examinations. Urgent procedures were not described.

Table 2. Different methods of triaging patients before endoscopy.

Study	History	CBC	CXR	CT	PCR
Al Mahtab et al. [12]	Yes	Yes	Yes
Alboraie et al. [1]	Yes	Yes			Yes
An et al. [14]	Yes	Yes	Yes	Yes	Yes
Mauro et al. [15]				Yes	Yes
Becq et al. [9]					Yes
Chen et al. [16]					Yes
Dioscoridi and Carrisi [17]	Yes
Ebigbo et al. [7]	Yes				15%
Forbes et al. [19]	Yes
Garbe et al. [20]	Yes				Yes
Manes et al. [34]					Yes
Huang et al. [23]					Yes
Ikehara et al. [24]				Yes	Yes
Kim et al. [26]	Yes	Yes		Yes	Yes
Kushnir et al. [27]	Yes				Yes
Liu et al. [29]	Yes			Yes	Yes
Lui et al. [11]	Yes
Maida et al. [32]	Yes
Moreels [38]					Yes
Navaneethan et al. [39]	Temperature and COVID-19 symptoms
O’Grady et al. [40]		Yes			Yes
Medas et al. [42]	Yes, by questionnaire
Moraveji et al. [44]					Yes
Sobani et al. [45]	Yes	Yes	Yes	Yes	Yes
D'Ovidio et al. [08]	YES
Belle et al. [47]					Yes
Zorniak et al. [49]	Yes				Yes

CBC: complete blood count; CXR: chest X ray; CT: computed tomography; PCR: polymerase chain reaction.

Figure 1. The PRISMA flow diagram for the retrieved studies.

Figure 2. Origin and number of studies participating data in this systematic review.

Figure 3. Types and relative volume reduction of different endoscopic procedures performed during COVID-19 pandemic in different continents compared to data before the pandemic (data from 31 centres. Each continent is represented by data form one big country).

Table 3. Diagnostic yield of urgent upper endoscopy during lockdown period in comparison to the previous year.

	Salerno et al. [43]		D'Ovidio et al. [8]
	Before	During	Before	During
Esophago-gastro-duodenoscopy positive for findings (no., %)
NVUGB	345 (56.1%)	240 (62.6%)
VUGB	105 (17%)	56 (14.6%)
Foreign body	84 (13.6%)	36 (9.4%)
Caustic ingestion	24 (4%)	11 (3%)
Others	57 (9.3%)	40 (10.4%)
Severity of bleeding endoscopic stigmata (Forrest classification)
III Clean‐based ulcer			7 (64%)	3 (30%)
IIc Flat pigmented haematinic			0	2 (20%)
IIb Adherent clot			3 (27%)	0
IIa Non‐bleeding visible vessel			0	3 (30%)
Ib Active oozing			1 (9%)	2 (20%)

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Data availability statement

The data associated with this review is available from the corresponding author upon request.