Tan Xiangzhou, Guo Jianping, Chen Zihua, Königsrainer Alfred, Wichmann Dörte
Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.
Department of General, Visceral and Transplantation Surgery, Interdisciplinary Endoscopy Unit, University Hospital Tübingen, Tübingen, Germany.
Therap Adv Gastroenterol. 2021 Aug 30;14:17562848211042185. doi: 10.1177/17562848211042185. eCollection 2021.
The impact of gastrointestinal endoscopy on COVID-19 infection remains poorly investigated. We herein performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 in patients undergoing gastrointestinal endoscopy.
Ovid Medline, Ovid EMBASE, Ovid the Cochrane Library, and other electronic databases were searched until 30 November 2020 to identify publications with confirmed COVID-19 infection in patients undergoing gastrointestinal endoscopy. The primary outcomes were SARS-CoV-2 transmission, personal protective equipment use, rates of case fatality, complications, and procedural success.
A total of 18 articles involving 329 patients were included in this systematic review and meta-analysis. The overall basic reproduction rate is 0.37, while the subgroup results from Asia, Europe, and North America are 0.13, 0.44, and 0.33, respectively. The differences in personal protective equipment use between the positive transmission and non-transmission group are mainly in isolation gowns, N95 or equivalent masks, and goggles or face-shields. The rate of case fatality, complication, and procedural success are 0.17 (95% confidence interval = 0.02-0.38), 0.00 (95% confidence interval = 0.00-0.02), and 0.89 (95% confidence interval = 0.50-1.00), respectively. The fatality rate in Europe was the highest (0.23, 95% confidence interval = 0.04-0.50), which is significantly different from other continents ( = 0.034).
The risk of SARS-CoV-2 transmission within gastrointestinal endoscopy units is considerably low if proper use of personal protective equipment is applied. Similarly, a low fatality and complication rate, as well as a high procedural success rate, indicated that a full recovery of endoscopic units should be considered.
胃肠道内镜检查对新型冠状病毒肺炎（COVID-19）感染的影响仍未得到充分研究。我们在此进行了一项系统评价和荟萃分析，以评估接受胃肠道内镜检查的COVID-19患者的结局。
检索了Ovid Medline、Ovid EMBASE、Ovid考克兰图书馆及其他电子数据库，直至2020年11月30日，以确定接受胃肠道内镜检查且确诊为COVID-19感染患者的相关出版物。主要结局包括严重急性呼吸综合征冠状病毒2（SARS-CoV-2）传播、个人防护装备使用情况、病死率、并发症发生率及操作成功率。
本系统评价和荟萃分析共纳入18篇文章，涉及329例患者。总体基本再生数为0.37，而亚洲、欧洲和北美的亚组结果分别为0.13、0.44和0.33。阳性传播组与非传播组在个人防护装备使用方面的差异主要体现在隔离衣、N95或等效口罩以及护目镜或面罩上。病死率、并发症发生率和操作成功率分别为0.17（95%置信区间=0.02 - 0.38）、0.00（95%置信区间=0.00 - 0.02）和0.89（95%置信区间=0.50 - 1.00）。欧洲的病死率最高（0.23，95%置信区间=0.04 - 0.50），与其他各大洲有显著差异（P = 0.034）。
如果正确使用个人防护装备，胃肠道内镜检查单元内SARS-CoV-2传播的风险相当低。同样，低病死率和并发症发生率以及高操作成功率表明应考虑全面恢复内镜检查单元的工作。
