Javier Crespo1,2, Carlos Fernández Carrillo3,2, Paula Iruzubieta1,2, Marta Hernández-Conde3,2, Laura Rasines1,2, Francisco Jorquera4,2, Agustín Albillos5,2, Rafael Bañares6,2, Pedro Mora7, Inmaculada Fernández Vázquez8, Manuel Hernández-Guerra9, Juan Turnes10, José Luis Calleja3,2. 1. Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, Health Research Institute Valdecilla, Santander, Spain. 2. Biomedical Research Networking Center of Hepatic and Digestive Diseases, Institute of Health Carlos III, Madrid, Spain. 3. Department of Gastroenterology and Hepatology, Puerta de Hierro-Majadahonda University Hospital, Health Research Institute Puerta de Hierro - Segovia de Arana, Madrid, Spain. 4. Department of Gastroenterology, León University Hospital Complex, Biomedicine Institute, University of León, León, Spain. 5. Department of Gastroenterology and Hepatology, Ramón y Cajal University Hospital, University of Alcalá, Ramón y Cajal Institute for Health Research, Madrid, Spain. 6. Department of Gastroenterology, Gregorio Marañón General University Hospital, Health Research Institute Gregorio Marañón, Complutense University of Madrid, Madrid, Spain. 7. Department of Gastroenterology, La Paz University Hospital, Hospital La Paz Institute for Health Research, Madrid, Spain. 8. Liver Unit, University Hospital 12 de Octubre, Research Institute Hospital 12 de Octubre, Madrid, Spain. 9. Department of Gastroenterology and Hepatology, Canarias University Hospital, La Laguna, Spain. 10. Department of Gastroenterology and Hepatology, Galicia Sur Health Research Institute, Pontevedra University Hospital Complex, Pontevedra, Spain.
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.
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-19patient 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.
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