MASSIVE IMPACT OF COVID-19 PANDEMIC ON GASTROENTEROLOGY AND HEPATOLOGY DEPARTMENTS AND DOCTORS IN SPAIN

Background and aim Significant human and material resources have been diverted to COVID-19. Healthcare workers are at high risk of SARS-CoV-2 infection. We assess the impact of the COVID-19 pandemic on Gastroenterology and Hepatology departments and specialists in Spain. Methods 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 cancellation of elective liver transplant and TIPS. 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 due to 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.