TY - JOUR
T1 - The role of endoscopy and findings in COVID-19 patients, an early North American Cohort
AU - North American Alliance for the Study of Digestive Manifestations of COVID-19
AU - Kuftinec, Gabriela
AU - Elmunzer, B. Joseph
AU - Amin, Sunil
AU - Elmunzer, Joseph
AU - Spitzer, Rebecca L.
AU - Foster, Lydia D.
AU - Merchant, Ambreen A.
AU - Howard, Eric F.
AU - Patel, Vaishali A.
AU - West, Mary K.
AU - Qayad, Emad
AU - Nustas, Rosemary
AU - Zakaria, Ali
AU - Piper, Marc S.
AU - Taylor, Jason R.
AU - Jaza, Lujain
AU - Forbes, Nauzer
AU - Chau, Millie
AU - Lara, Luis F.
AU - Papachristou, Georgios I.
AU - Volk, Michael L.
AU - Hilson, Liam G.
AU - Zhou, Selena
AU - Kushnir, Vladimir M.
AU - Lenyo, Alexandria M.
AU - McLeod, Caroline G.
AU - Kuftinec, Gabriela N.
AU - Yadav, Dhiraj
AU - Fox, Charlie
AU - Kolb, Jennifer M.
AU - Pawa, Swati
AU - Pawa, Rishi
AU - Canakis, Andrew
AU - Huang, Christopher
AU - Jamil, Laith H.
AU - Aneese, Andrew M.
AU - Glamour, Benita K.
AU - Smith, Zachary L.
AU - Hanley, Katherine A.
AU - Wood, Jordan
AU - Patel, Harsh K.
AU - Shah, Janak N.
AU - Agarunov, Emil
AU - Sethi, Amrita
AU - Fogel, Evan L.
AU - McNulty, Gail
AU - Haseeb, Abdul
AU - Trieu, Judy A.
AU - Dixon, Rebekah E.
AU - Yang, Jeong Yun
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background and aims: Gastrointestinal manifestations in patients with COVID-19 are common but the role of endoscopy in this patient population remains unclear. We investigated the need for endoscopic procedures, their findings, and impact on patient care in a systematic and geographically diverse sample of patients hospitalized with COVID-19. Methods: As part of the North American Alliance for the Study of Digestive Manifestations of COVID-19, we identified consecutive patients hospitalized with COVID-19 at 36 medical centers in the USA and Canada. We performed a secondary analysis of patients who underwent endoscopy, collecting information on endoscopic indications, findings, interventions, staffing, procedure location, anesthesia utilization, and adverse events. Results: Data were collected on 1992 patients; 24 (1.2%) underwent 27 endoscopic procedures (18 upper endoscopies, 7 colonoscopies, 2 endoscopic retrograde cholangiopancreatographies). The most common indications were: gastrointestinal bleeding (13) and enteral access (6). The most common findings were erosive or inflammatory changes. Ten patients underwent an endoscopic intervention for hemostatic therapy (2), enteral access (6), or biliary obstruction (2). Half of cases employed anesthesiology support; no sedation-related adverse events were reported. One-third of cases were performed in the intensive care setting and one quarter in the endoscopy unit. Conclusions: In this large, systematic, geographically diverse cohort of patients hospitalized with COVID-19 in North America, very few patients underwent endoscopy despite a high prevalence of gastrointestinal manifestations. Almost all endoscopic findings and interventions were thought related to critical illness rather than direct viral injury. This systematic assessment of endoscopic necessity and outcomes may help guide resource allocation in the event of ongoing and future surges.
AB - Background and aims: Gastrointestinal manifestations in patients with COVID-19 are common but the role of endoscopy in this patient population remains unclear. We investigated the need for endoscopic procedures, their findings, and impact on patient care in a systematic and geographically diverse sample of patients hospitalized with COVID-19. Methods: As part of the North American Alliance for the Study of Digestive Manifestations of COVID-19, we identified consecutive patients hospitalized with COVID-19 at 36 medical centers in the USA and Canada. We performed a secondary analysis of patients who underwent endoscopy, collecting information on endoscopic indications, findings, interventions, staffing, procedure location, anesthesia utilization, and adverse events. Results: Data were collected on 1992 patients; 24 (1.2%) underwent 27 endoscopic procedures (18 upper endoscopies, 7 colonoscopies, 2 endoscopic retrograde cholangiopancreatographies). The most common indications were: gastrointestinal bleeding (13) and enteral access (6). The most common findings were erosive or inflammatory changes. Ten patients underwent an endoscopic intervention for hemostatic therapy (2), enteral access (6), or biliary obstruction (2). Half of cases employed anesthesiology support; no sedation-related adverse events were reported. One-third of cases were performed in the intensive care setting and one quarter in the endoscopy unit. Conclusions: In this large, systematic, geographically diverse cohort of patients hospitalized with COVID-19 in North America, very few patients underwent endoscopy despite a high prevalence of gastrointestinal manifestations. Almost all endoscopic findings and interventions were thought related to critical illness rather than direct viral injury. This systematic assessment of endoscopic necessity and outcomes may help guide resource allocation in the event of ongoing and future surges.
KW - Endoscopy
KW - Enteral access
KW - GI bleeding
KW - SARS-CoV-2
KW - Viral Injury
UR - http://www.scopus.com/inward/record.url?scp=85105708182&partnerID=8YFLogxK
U2 - 10.1186/s12876-021-01796-4
DO - 10.1186/s12876-021-01796-4
M3 - Article
C2 - 33962582
AN - SCOPUS:85105708182
SN - 1471-230X
VL - 21
JO - BMC Gastroenterology
JF - BMC Gastroenterology
IS - 1
M1 - 205
ER -