UEG Week Virtual 2020 Congress Review - 5

UEG Week Congress Review

COVID-19 derails GI practice
across the globe, leaving one in 10
specialists infected
An internet-based survey conducted during the early months
of the COVID-19 pandemic has illustrated the massive toll taken
on gastrointestinal (GI) practice and on gastroenterologists
working in hospitals and private practices around the world.
Personal protective equipment (PPE) was in short supply, and
many hospital-based GI specialists were redeployed to care for
COVID-19 patients. As a result, almost one in 10 specialists had
tested positive for COVID-19 by April/May 2020.
The anonymous 25-item survey was sent out via email between
April and May 2020 to recipients within the UEG community.
Two thousand and sixty-three valid responses were received
from hospital consultants and heads of department, trainee
gastroenterologists, private practitioners, surgeons, medical
students, and allied health professionals from 114 countries.
Most survey respondents were working in university or general
hospitals and/or in private practice.
A lack of PPE was illustrated by the finding that 44.1% of survey
respondents said they were wearing surgical masks during
upper GI endoscopy - a procedure known to be highly aerosol
generating. Only 33.5% of respondents were wearing FFP2
masks and 15.1% of respondents were wearing the guidelinerecommended FFP3 masks during upper GI endoscopy.
Similar data were reported for mask use during lower GI
endoscopy. The survey also found that 37% of hospital GIs had
been redeployed to care for COVID-19 patients, with 48% of
redeployed doctors being GI trainees. Perhaps, unsurprisingly
given these findings, 9.7% of respondents had already tested
positive for COVID-19.
The impact of COVID-19 on GI research was also found to be
substantial: 47% of research centres had totally suspended all
human clinical trials, and 36% were only allowed to conduct
research under certain circumstances. Less than 5% of research
centres were continuing their work as usual.
"GIs across the world in all settings face unprecedented
challenges," said Henriette Heinrich from the University of
Zurich in Switzerland, who presented the survey findings. "PPE
availability and testing for COVID-19 is a major concern for a lot
of GIs...and 10% of GIs surveyed got infected with COVID-19.
"GI trainees are redeployed to a high degree, affecting their
training possibilities."

IBD patients may be at increased risk
of death from COVID-19
People with IBD may be at increased risk of death from
COVID-19, according to an updated analysis of the Surveillance
Epidemiology of Coronavirus Under Research Exclusion for
Inflammatory Bowel Disease (SECURE-IBD) database (https://
covidibd.org/). The latest analysis included 959 IBD patients
with confirmed COVID-19 from 40 countries (median age 43
years; 52.3% men; 83.5% white; 57.0% with CD). Of these, 86
(9.0%) developed severe COVID-19 (defined as a composite of
intensive care unit admission, ventilator use, and/or death), 320
(33.4%) were hospitalised and 37 (3.9%) died. Age-standardised
mortality ratios (SMRs) for IBD patients were 2.02 (95% CI
1.36-2.69), 1.66 (95% CI 1.12-2.20), and 1.86 (95% CI 1.25-2.47)
relative to data from China1, Italy2, and the US3, respectively. The
differences between the datasets were statistically significant.
The investigators also conducted multivariable logistic
regression analyses and identified increasing age (adjusted
odds ratio [aOR] 1.04; 95% CI 1.02-1.06; p<0.0001), one
comorbidity in addition to IBD (aOR 2.60, 95% CI 1.34-5.01;
p<0.004)), ≥2 comorbidities in addition to IBD (aOR 4.80, 95% CI
2.40-9.61; p<0.0001), systemic corticosteroid use (aOR 5.12, 95%
CI 2.47-10.92; p<0.0001), and sulfasalazine or 5-aminosalicylate
use (aOR 2.03, 95% CI 1.14-3.61; p<0.02) as being risk factors for
severe COVID-19. Gender, IBD diagnosis, disease severity, being
a current smoker, body mass index ≥30, and tumor necrosis
factor (TNF) antagonist treatment were not associated with
severe COVID-19.
"In this updated analysis from the SECURE-IBD registry,
we observed that, in almost 1,000 patients, increasing age,
comorbidities and corticosteroids are associated with severe
COVID-19 outcomes," said Ryan Ungaro from the Icahn School
of Medicine at Mount Sinai, New York, USA. "TNF medications
do not appear to be associated with severe COVID-19 outcomes,
providing reassurance that these medications can be continued
during this pandemic.
"As we accumulate more cases, we will be able to analyse other
biologic classes or small molecules to better understand [how]
non-TNF-targeted therapies impact on COVID-19 outcomes."
1. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease
Control and Prevention. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41(2):145-151.
2. Onder G, et al. JAMA 2020;323(18):1775-1776.
3. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/nvss/vsrr/covid19/
index.htm.

http://https:// http://www.covidibd.org/ https://www.cdc.gov/nchs/nvss/vsrr/covid19/

UEG Week Virtual 2020 Congress Review

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