Characteristics and Outcomes of Endoscopies Before and During the COVID-19 Pandemic in New York.

Introduction The COVID-19 pandemic drastically changed hospital workflows. This study aimed to characterize differences in gastrointestinal endoscopies in the New York metropolitan region before, during, and after the first wave of the pandemic. Methods Across three hospitals, we compared demographics, indications, and yield of endoscopies before and after March 16, 2020, the date on which elective procedures were cancelled, as well as a recovery period for five months after they were resumed. Results A total of 9,401 procedures before and 332 procedures were performed during the first wave. Females comprised 57% and 44% of patients (p <0.01), respectively. There was a decline in the proportion of Black (15% vs. 7%, p <0.02) and Hispanic patients (29% vs. 16%, p <0.02) undergoing outpatient procedures. There was a significant rise in urgent indications such as bleeding and jaundice. There was an increase in the diagnostic yield of all esophagogastroduodenoscopies for bleeding (p <0.01) and in outpatient endoscopic ultrasounds for malignancy (p = 0.01), but no increase in yield of inpatient colonoscopy for bleeding. Review of 7,475 procedures during the recovery period showed a return to many non-urgent indications, but still showed decreased proportions of Hispanic and male patients compared to the pre-pandemic period. Discussion / Conclusion Lower proportions of Black and Hispanic patients underwent outpatient endoscopies during and after the first wave. The proportion of procedures done for emergent indications, and their diagnostic yield, increased during the pandemic, suggesting a higher threshold to perform endoscopy. In resource-sparing conditions, clinicians should pay attention to thresholds to perform colonoscopy for bleeding, and to racial disparities in outpatient healthcare access.