Impact of the SARS-COV-2 pandemic on gastroenterology units in Italy: A national survey

Introduction: In Italy, the spread of the SARS-CoV-2 pandemic has stressed the entire healthcare system and required a huge re-organization of many divisions, including those of Gastroenterology Many of them have been converted to COVID Units to deal with the emergency, while others were forced to reduce the routine workload to prevent the infection spreading, with consequent impairment of the health services provided and potential consequences for patients Aims & Methods: This is a prospective observational web-based survey aimed to assess the impact of SARS-CoV-2 pandemic on Gastroenterology Units in Italy All members of the Italian Society of Gastroenterology (SIGE) were invited to answer a 39-point multiple-choice web-based survey Results: Data of 121 hospitals from all 20 Italian regions were analyzed Overall, 10 7% of Gastroenterology divisions have been converted to COVID Units Outpatients consultations, endoscopic and ultrasound procedures were limited to urgencies and oncology indications in 85 1%, 96 2% and 72 2% of Units, respectively, and 46 7% of Units suspended the screening for colorectal cancer In order to guarantee the ordinary followup of outpatients, 83/121 (68 6%) divisions activated a remote consultancy service (63 9% by phone, 31 3% by email, 4 8% by video) Overall, 112/121 (92 6%) GI Units issued and followed a specific protocol for the management of patients with suspected or confirmed SARS-CoV-2 infection The 72 2% of the staff received proper training for the use of personal protective equipment, although 45 5% did not have sufficient devices for an adequate replacement With regard to PPE availability, N95/ FFP2-3 masks were available in 91/121 (75 2%), surgical masks in 115/121 (95 0%), gloves in 117/121 (96 7%), disposable gown in 100/121 (82 6%), hairnet in 104/121 (85 9%), goggles in 78/121 (64 5%) and boots in 57/121 (47 1%) of divisions Finally, in 41/121 GI divisions (33 9%) there was at least one healthcare professional who got infected, in a total of 132 subjects, of which 121/132 from divisions not-converted to COVID Units and 75/132 from high-prevalence areas In 56/121 (46 3%) hospitals, the exposed personnel undergo a nasopharyngeal swab to ruleout infection only if symptomatic Conclusion: This is the first study to evaluate, at a country level, the impact of SARS-CoV-2 outbreak on Gastroenterology divisions Substantial changes of practice and reduction of procedures have been recorded in the entire country The long-term impact of such modifications is difficult to estimate but potentially very risky for many digestive diseases