Impact of the COVID-19 pandemic on gastrointestinal endoscopy in the Netherlands: analysis of a prospective endoscopy database
Background COVID-19 has dramatically affected gastrointestinal endoscopy practice. We aimed to investigate its impact on procedure types, indications, and findings.
Methods We retrospectively analyzed endoscopies performed in 15 Dutch hospitals by comparing periods 15 March to 25 June of 2019 and 2020 using the prospective Trans.IT database.
Results During lockdown in 2020, 9776 patients underwent endoscopy compared with 19 296 in 2019. Gastroscopies decreased by 57 % (from 7846 to 4467) and colonoscopies by 45 % (from 12219 to 5609), whereas endoscopic retrograde cholangiopancreatography volumes remained comparable (from 578 to 522). Although endoscopy results indicative of cancer decreased (from 524 to 340), the likelihood of detecting cancer during endoscopy increased (2.7 % [95 % confidence interval (CI) 2.5 – 3.0] in 2019 versus 3.5 % [95 %CI 3.1 – 3.9] in 2020; P < 0.001). After lifting of lockdown, endoscopy volumes started to return to normal, except for colorectal cancer screening.
Conclusions Fewer endoscopies were performed during the COVID-19 lockdown, leading to a significant reduction in the absolute detection of cancer. Endoscopies increased rapidly after lockdown, except for colorectal cancer screening.
* These authors contributed equally to this work.
# The Trans.IT foundation study group: M. Kerkhof (Groene Hart Ziekenhuis, Gouda); R.M.E. Slangen (HagaZiekenhuis, Den Haag), P.J. Bus (Laurentius Ziekenhuis, Roermond); F.J.G.M. Kubben (Maasstad Ziekenhuis, Rotterdam); W.J. Thijs (Martini Ziekenhuis, Groningen); M.J.M. Groenen (Rijnstate Ziekenhuis, Arnhem), E. A. Hoboken (Rode Kruis Ziekenhuis, Beverwijk), W. Bruins Slot (Spaarne Gasthuis, Haarlem), L. Wormmeester (Treant Zorggroep, Hoogeveen), F. Vleggaar (UMC Utrecht, Utrecht), L.A. Noach (Ziekenhuis Amstelland, Amstelveen), J.J. Uil (Ziekenhuis Gelderse Vallei, Ede); M. Rasica (Bravis Ziekenhuis, Roosendaal); M.E. van Leerdam (Antoni van Leeuwenhoek, Amsterdam and Leiden University Medical Center, Leiden); E.J. Kuipers (Erasmus Medical Center, Rotterdam).
Received: 02 July 2020
Accepted: 08 September 2020
20 October 2020 (online)
© 2020. Thieme. All rights reserved.
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- 1 Zhou P, Yang X-L, Wang X-G. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579: 270-273
- 2 Medicine JHUo Coronavirus Resource Center. COVID-19 dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Baltimore: Johns Hopkins University of Medicine. https://coronavirus.jhu.edu/map.html Last accessed September 2020
- 3 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; 52: 483-490
- 4 Zhang Y, Zhang X, Liu L. et al. Suggestions for infection prevention and control in digestive endoscopy during current 2019-nCoV pneumonia outbreak in Wuhan, Hubei province, China. Endoscopy 2020; 52: 312-314
- 5 National Institute for Health and Environment. Ministry of Health, Welfare and Sport. COVID-19 (novel coronavirus). https://www.rivm.nl/ Last accessed September 2020
- 6 Groenen MJ, Hirs W, Becker H. et al. Gastrointestinal endoscopic terminology coding (GET-C): a WHO-approved extension of the ICD-10. Dig Dis Sci 2007; 52: 1004-1008
- 7 Groenen MJ, Kuipers EJ, van Berge Henegouwen GP. et al. Computerisation of endoscopy reports using standard reports and text blocks. Neth J Med 2006; 64: 78-83
- 8 Soekhoe JK, Groenen MJ, van Ginneken AM. et al. Computerized endoscopic reporting is no more time-consuming than reporting with conventional methods. Eur J Intern Med 2007; 18: 321-325
- 9 Groenen MJ, van Buuren HR, van Berge Henegouwen GP. et al. Validation study of automatically generated codes in colonoscopy using the endoscopic report system Endobase. Scand J Gastroenterol 2010; 45: 1121-1126
- 10 Bitam KPI Online. 2020 https://kpionline.bitam.com
- 11 Forbes N, Smith ZL, Spitzer RL. et al. Changes in gastroenterology and endoscopy practices in response to the coronavirus 2019 pandemic: results from a North American survey. Gastroenterology 2020; 159: 772-774
- 12 Schreuders EH, Ruco A, Rabeneck L. et al. Colorectal cancer screening: a global overview of existing programmes. Gut 2015; 64: 1637-1649
- 13 Sud A, Jones M, Broggio J. et al. Collateral damage: the impact on outcomes from cancer surgery of the COVID-19 pandemic. Ann Oncol 2020; 31: 1065-1074
- 14 Schmiderer A, Schwaighofer H, Niederreiter L. et al. Decline in acute upper gastrointestinal bleeding during Covid-19 pandemic after lockdown in Austria. Endoscopy 2020; DOI: 10.1055/a-1178-4656.
- 15 Kushnir VM, Berzin TM, Elmunzer BJ. et al. Plans to reactivate gastroenterology practices following the COVID-19 pandemic: a survey of North American centers. Clin Gastroenterol Hepatol 2020; 18: 2287-2294