Massive impact of coronavirus disease 2019 pandemic on gastroenterology and hepatology departments and doctors in Spain

J Gastroenterol Hepatol. 2021 Jun;36(6):1627-1633. doi: 10.1111/jgh.15340. Epub 2020 Dec 14.

Abstract

Background and aim: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Endoscopy; Hepatology > clinical > hepatocellular carcinoma; Hepatology > epidemiology; Liver; SARS-CoV-2.

MeSH terms

  • Attitude of Health Personnel
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Digestive System Surgical Procedures / statistics & numerical data
  • Endoscopy, Gastrointestinal / statistics & numerical data
  • Gastroenterology* / methods
  • Gastroenterology* / organization & administration
  • Gastroenterology* / statistics & numerical data
  • Gastrointestinal Diseases* / epidemiology
  • Gastrointestinal Diseases* / therapy
  • Health Care Surveys
  • Health Personnel* / psychology
  • Health Personnel* / statistics & numerical data
  • Hospital Departments / statistics & numerical data
  • Humans
  • Infection Control / methods
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Needs Assessment
  • Occupational Exposure* / prevention & control
  • Occupational Exposure* / standards
  • Organizational Innovation
  • SARS-CoV-2
  • Spain / epidemiology