Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, Health Research Institute Valdecilla, Santander, Spain.
Biomedical Research Networking Center of Hepatic and Digestive Diseases, Institute of Health Carlos III, Madrid, Spain.
J Gastroenterol Hepatol. 2021 Jun;36(6):1627-1633. doi: 10.1111/jgh.15340. Epub 2020 Dec 14.
Significant human and material resources have been diverted to coronavirus disease 2019 (COVID-19). Healthcare workers are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We assess the impact of the COVID-19 pandemic on gastroenterology and hepatology departments and specialists in Spain.
This study involves a nationwide survey addressing the impact of COVID-19 on resources, procedures, and physicians of gastroenterology and hepatology departments in 81 hospitals representative of the Spanish National Health Service.
Overall, 41.8% of hospital beds and 40.7% of gastroenterology and hepatology beds were allocated to COVID-19 patient care, as well as 24.8% of gastroenterologists and 58.3% of residents. Outpatient visits, abdominal ultrasounds, and endoscopies were reduced by 81.8-91.9%. Nine large university hospitals had 75% and 89% reductions in therapeutic endoscopies and hepatocellular carcinoma surgery, respectively, with cancelation of elective liver transplant and transjugular intrahepatic portosystemic shunt. Prevalence of infected physicians was 10.6% and was dependent on regional population incidence (r = 0.74, P = 0.001), with 11% hospitalized and one physician dying. Up to 63.4% of physicians may have been infected before or shortly after Spain entered lockdown, 57% of them having recently performed endoscopies. Adequate protection was acknowledged in > 80% hospitals, but only 2.9% performed regular SARS-CoV-2 testing.
The impact of the COVID-19 pandemic on healthcare delivery has been massive. A wave of gastroenterology-related complications is expected because of resource diversion. Gastroenterologists have a high prevalence of infection, although they may have been infected during a first phase of lower awareness and protection. Regular SARS-CoV-2 screening, adequate protection, and quick reorganization of healthcare resources are still needed.
大量的人力和物力资源被转移到 2019 年冠状病毒病（COVID-19）上。医护人员感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的风险很高。我们评估了 COVID-19 大流行对西班牙消化内科和肝脏病学部门及专家的影响。
本研究通过一项全国性调查，评估了 81 家代表西班牙国家卫生服务的医院的 COVID-19 对资源、程序和消化内科和肝脏病学部门医生的影响。
总体而言，41.8%的医院床位和 40.7%的消化内科和肝脏病学床位用于 COVID-19 患者的护理，24.8%的胃肠病学家和 58.3%的住院医师也参与其中。门诊就诊、腹部超声和内镜检查减少了 81.8-91.9%。9 家大型大学医院的治疗性内镜检查和肝细胞癌手术分别减少了 75%和 89%，同时取消了择期肝移植和经颈静脉肝内门体分流术。感染医生的患病率为 10.6%，且与地区人口发病率相关（r=0.74，P=0.001），其中 11%住院，1 名医生死亡。在西班牙进入封锁之前或之后不久，可能有多达 63.4%的医生已经感染，其中 57%的医生最近进行了内镜检查。超过 80%的医院认为有足够的保护，但只有 2.9%的医院定期进行 SARS-CoV-2 检测。
COVID-19 大流行对医疗服务的影响是巨大的。由于资源转移，预计会出现一波与消化相关的并发症。尽管胃肠病学家感染率较高，但他们可能在意识和保护水平较低的第一阶段就已经感染。仍需要定期进行 SARS-CoV-2 筛查、提供充分的保护以及快速重组医疗资源。
