Resál Tamás, Bor Renáta, Szántó Kata, Fábián Anna, Rutka Mariann, Sacco Marco, Ribaldone Davide Guiseppe, Molander Pauliina, Nancey Stephane, Kopylov Uri, Vavricka Stephan, Drobne David, Lukas Milan, Farkas Klaudia, Szepes Zoltán, Molnár Tamás
Gastroenterology Unit, Department of Medicine, University of Szeged, Szeged, Hungary.
Endoscopy Unit, AOU Città della Salute e della Scienza di Torino, University of Turin, Torino, Piemonte, Italy.
Therap Adv Gastroenterol. 2021 Apr 22;14:17562848211006678. doi: 10.1177/17562848211006678. eCollection 2021.
The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to healthcare. Staff and patients are at increased risk during an examination or intervention, so certain restrictions ought to be introduced. Hence, we aimed to measure the effect of the pandemic on endoscopy units in real-life settings.
This was an observational, cross-sectional, questionnaire-based study, carried out between 7 April and 15 June 2020. Responds came from many countries, and the participation was voluntary. The survey contained 40 questions, which evaluated the effect of the COVID-19 pandemic on the endoscopy units and assessed the infection control.
A total of 312 questionnaires were filled, 120 from Hungary, and 192 internationally, and 54 questionnaires (17.3%) were sent from high-risk countries; 84.9% of the gastroenterologists declared that they read the European Society of Gastrointestinal Endoscopy (ESGE) statement, while only 32.1% participated in any advanced training at their workplace. Overall, 92.1% of gastroenterologists realized risk stratification, and 72.1% claimed to have enough protective equipment. In 52.6% of the endoscopy units, at least one endoscopist had to discontinue the work due to any risk factor, while 40.6% reported that the reduced staff did not affect the workflow. Gastroenterologists considered that the five most important examinations both in low and high-risk patients are the following: lower/upper gastrointestinal (GI) bleeding with hemodynamic instability, endoscopic retrograde cholangiopancreatography (ERCP) in obstructive jaundice, foreign body in the esophagus, ERCP in acute biliary pancreatitis, and iron deficiency anemia with hemodynamic instability, which correlates well with the ESGE recommendation. Significant correlation was found in the usage of the necessary protective equipment in high-risk patients depending on the countries ( < 0.001).
The survey found weak correlation in preliminary training depending on countries; nevertheless, in Hungary during the examined period, endoscopists considered the recommendations more strictly than in other countries. Although many physicians left the endoscopy lab, the workflow was not affected, probably due to the reduced number of examinations.
2019年冠状病毒病（COVID-19）大流行给医疗保健带来了挑战。在检查或干预期间，医护人员和患者面临的风险增加，因此应引入某些限制措施。因此，我们旨在衡量大流行对现实环境中内镜科室的影响。
这是一项基于问卷调查的观察性横断面研究，于2020年4月7日至6月15日进行。回复来自许多国家，参与是自愿的。该调查包含40个问题，评估了COVID-19大流行对内镜科室的影响并评估了感染控制情况。
共填写了312份问卷，其中120份来自匈牙利，192份来自国际，54份问卷（17.3%）来自高风险国家；84.9%的胃肠病学家表示他们阅读了欧洲胃肠内镜学会（ESGE）的声明，而只有32.1%的人在工作场所参加了任何高级培训。总体而言，92.1%的胃肠病学家进行了风险分层，72.1%的人声称有足够的防护设备。在52.6%的内镜科室中，至少有一名内镜医师因任何风险因素不得不停止工作，而40.6%的人报告说人员减少并未影响工作流程。胃肠病学家认为，低风险和高风险患者最重要的五项检查如下：血流动力学不稳定的下/上消化道（GI）出血、梗阻性黄疸的内镜逆行胰胆管造影（ERCP）、食管异物、急性胆源性胰腺炎的ERCP以及血流动力学不稳定的缺铁性贫血，这与ESGE的建议高度相关。根据国家不同，高风险患者必要防护设备的使用存在显著相关性（<0.001）。
调查发现，初步培训因国家而异，相关性较弱；然而，在匈牙利的检查期间，内镜医师比其他国家更严格地考虑这些建议。尽管许多医生离开了内镜实验室，但工作流程并未受到影响，可能是由于检查数量减少。
