Improvement in appropriateness and diagnostic yield of fast-track endoscopy during the COVID-19 pandemic in Northern Italy.

BACKGROUND AND STUDY AIM: During the COVID-19 outbreak in Italy only fast-track endoscopic procedures have been performed; nevertheless, a significant drop in their number has been reported. We evaluated whether the pandemic has impacted the appropriateness and diagnostic yield of fast-track endoscopic procedures in comparison with those performed in 2019. PATIENTS AND METHODS: This retrospective survey has involved Endoscopic Services in Northern Italy; we compared data regarding endoscopic procedures performed in March and April 2020 with those performed in the same period in 2019. RESULTS: We observed in 2020 a reduction of 53.6% in the number of procedures. Patients undergoing endoscopy in 2020 were younger than in 2019. Both appropriate referral and diagnostic yield increased in 2020 and it regarded both upper and lower endoscopy. A higher rate of cancer was diagnosed in 2020 by upper endoscopy (3.6% vs 6.6%, p=0.04). CONCLUSIONS: The high level of inappropriate endoscopic referral registered in 2019 has significantly improved during the COVID-19 outbreak with an increase in the diagnostic yield.