Open AccessImpact of COVID-19 Pandemic and Lockdown on the Management of Upper Gastrointestinal Bleeding in the Emergency Department: A Cohort Study
Author(s) -
T. Addajou,
Rokhsi Soukaina,
S. Mrabti,
A. Sair,
A. Benhamdane,
Berraida Rida,
I. Elkoti,
Fedoua Rouibaa,
Ahmed Bourazza,
Sameer Hassan
Publication year - 2022
Publication title -
scholars journal of applied medical sciences
Language(s) - English
Resource type - Journals
eISSN - 2347-954X
pISSN - 2320-6691
DOI - 10.36347/sjams.2022.v10i04.015
Subject(s) - medicine , pandemic , emergency department , retrospective cohort study , upper gastrointestinal bleeding , cohort , covid-19 , cohort study , endoscopy , emergency medicine , disease , infectious disease (medical specialty) , psychiatry
Background and study aims: During the COVID-19 pandemic, endoscopic procedures were associated with a high risk of SARS-CoV-2 infection. However, in cases of upper gastrointestinal bleeding (UGIB), priority should be given to early endoscopy. The aim of this study was to assess the impact of the pandemic and the lockdown on the performance of digestive endoscopy for UGIB. Patients and methods: This is a retrospective observational cohort of 350 patients, conducted between January 2019 and December 2020, in the emergency endoscopy department of our institution. We have divided our patients into two groups, according to the period in which they were admitted (respectively pre-pandemic and pandemic periods corresponding to the year 2019 and 2020), and we have split the pandemic period into 3 subgroups according to the lockdown, each of these 3 phases was compared to its counterpart of the pre-pandemic period by adapting the same dates. Results: There was no difference in the number of admissions for UGIB before and after the COVID-19 pandemic. However, patients admitted during the pandemic period were significantly older. Peptic ulcer remained the main cause of UGIB in both study periods, with a significant decrease in the pandemic period. The subgroups analysis of the pandemic and pre-pandemic period showed that patients admitted during the lockdown phase were significantly older, with a significant decrease in the ulcerative origin of UGIB and an increase in the need for endoscopic haemostasis procedures, whereas during the post-lockdown period, there was furthermore an increase in the number of patients with UGIB of neoplastic origin. Conclusion: Despite the current epidemiological context, digestive endoscopy must be performed within the usual timeframe while adopting adequate precaution measures. Our study suggest that the reorganisation of our endoscopy department during the pandemic was effective in coping with routine endoscopic emergencies during this