You are here

Article Text

Article menu
Download PDFPDF
Endoscopy news
Effects of SARS-CoV-2 emergency measures on high-risk lesions detection: a multicentre cross-sectional study
  1. Manuele Furnari1,
  2. Leonardo Henry Eusebi2,
  3. Edoardo Savarino3,
  4. Carlo Petruzzellis4,
  5. Gianluca Esposito5,
  6. Marcello Maida6,
  7. Luigi Ricciardiello2,
  8. Silvia Pecere7,
  9. Andrea Buda8,9,
  10. Manuela De Bona10,
  11. Cristiano Spada4,
  12. Emilio Di Giulio11,
  13. Guido Costamagna12,
  14. Ivo Boskoski7,
  15. Edoardo G Giannini13
  16. The Young-ENDO-ITA Study Group
    1. 1 Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genova, Italy
    2. 2 Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
    3. 3 Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
    4. 4 Digestive Endoscopy Unit, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy
    5. 5 Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
    6. 6 Gastroenterology and Endoscopy Unit, S Elia-Raimondi Hospital, Caltanissetta, Italy
    7. 7 Digestive Endoscopy Unit, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
    8. 8 Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, Italy
    9. 9 Gastroenterology and Digestive Endoscopy Unit, Ospedale Civile di Feltre, Feltre, Veneto, Italy
    10. 10 Department of Gastroenterology, Feltre, Belluno, Italy
    11. 11 Department of Medical-Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Roma, Italy
    12. 12 Digestive Endoscopy Unit, Catholic University, Gemelli University Hospital, Roma, Italy
    13. 13 Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genoa, Italy
    1. Correspondence to Dr Manuele Furnari, Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genova 16126, Italy; manuele.furnari{at}unige.it

    https://doi.org/10.1136/gutjnl-2020-323116

    Statistics from Altmetric.com

      Request Permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

      Message

      COVID-19 pandemic enforced the interruption of routine endoscopic examinations raising the issue of potential delays in the diagnosis of high-risk lesions. We conducted a multicentre study to assess the decrease of GI and pancreato-biliary high-risk lesions detection consequent to the reduction of the endoscopic activity. The lockdown period was compared to the equivalent timeframe of the previous 3 years. Endoscopic procedures decreased by 72.9% (elective 72.4% and urgent 51.3%); the overall cases of high-grade dysplasia/cancers decreased by 59.1% (23.4% pancreato-biliary cancers; 70.6% and 68.8% upper and lower GI lesions). The postemergency period should aim at limiting high-risk lesions delayed diagnoses.

      In more details

      A multicentre, retrospective, cross-sectional study was performed in eight tertiary centres, representative of Northern and Southern Italy, to assess the decrease of GI and pancreato-biliary lesions detected, as a consequence of the reduction of endoscopic procedures caused by the COVID-19 pandemic restrictions. Five were academic centres (62.5%), and all working groups were involved in research activities and training programmes.

      We collected data from the pandemic lockdown period from 9 March to 4 May (11°−18° week) of 2020, referred as P2; and the equivalent prepandemic period (11°−18° week) of 2019, referred as P1. Data from the corresponding periods of the previous 2 years (2017 and 2018) were also collected in order to assess trends of the last 3 years.

      Main parameters analysed were:

      • Type and number of elective and emergency procedures performed.

      • Detection of GI and pancreato-biliary high-risk lesions during elective procedures.

      Data analysis online

      Endoscopic procedures

      The total number of endoscopic procedures performed at the eight centres in P1 was 13 293 (median 1912/centre; IQ 25th–75th: 1135–2691) procedures against 3799 (median 408/centre; IQ 25th–75th: 331–842) performed in P2, thus representing an overall reduction of 71.4% (details shown in figure 1).

      Figure 1

      Percentage reduction of the global activities of the endoscopy units in P2 compared with P1. …

      View Full Text

      Footnotes

      • Twitter @manuelefurnari, @ivoboskoski

      • Collaborators The Young-ENDO-ITA Study Group: Stefano Angeletti; Federico Barbaro; Matteo Brunacci; Maria Cazzato; Vito Domenico Corleto; Maria Giulia Demarzo; Elisa Giambruno; Gaetano Morreale; Alessandro Moscatelli; Mario Pesenti; Lino Polese; Davide Risso; Giacomo Tamanini; and Fabiana Zingone.

      • Contributors MF, ES, LHE and GE conceived the study and wrote the manuscript. IB and EGG designed the study and wrote the manuscript. AB, EDG, AM, MDB, MGD, EG, GT and MC acquired data. FZ, LP, SA, VDC, MP and FB created and managed the database, searched literature and revised final manuscript. DR, CP, SP and MM analysed data. CS, LR and GC designed and revised the manuscript. All members of the Young-ENDO-ITA Study Group Study Group extracted and collected the data for each centre. All authors critically read and intellectually contributed to the manuscript.

      • Funding Personal funding to declare: Foundation for Cancer Research (AIRC) IG 21723 (to LR).

      • Competing interests Beyond the conduction of this study, IB declares to be: consultant for Apollo Endosurgery, Cook Medical and Boston Scientific; board member for Endo Tools; research grant recipient from Apollo Endosurgery; GC declares to be: consultant for and food and beverage compensation from Cook Medical, Boston Scientific and Olympus; ES declares to be: lecturer or consultant for Takeda, Janssen, Abbvie, MSD, Sofar, Malesci, Sandoz, Reckitt Benckiser and Medtronic; board member for Frasenius Kabi and BMS; research grant recipient from Unifarco, Sila and Sofar.

      • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

      • Provenance and peer review Not commissioned; internally peer reviewed.