Gastrointestinal Endoscopy Practices during the COVID-19 Pandemic
Summary
Since the emergence of COVID-19 in early 2020, gastroenterology units worldwide have rapidly adapted endoscopic services to balance urgent diagnostic and therapeutic needs against the risk of SARS-CoV-2 transmission. Endoscopy was reclassified as an aerosol-generating procedure, prompting the introduction of robust pre-procedure triage, universal symptom screening and, in many centres, routine viral testing. Infection prevention protocols were overhauled, with widespread use of enhanced personal protective equipment (PPE), installation of physical barriers and negative-pressure facilities where feasible. Non-urgent elective procedures were deferred or risk-stratified according to local prevalence, leading to substantial reductions in procedural throughput and delays in colorectal cancer screening. Simultaneously, emergency and high-priority indications—such as acute upper gastrointestinal bleeding or suspected malignancy—were prioritised. Training opportunities for endoscopy fellows were curtailed, and workforce deployment shifted to support critical care and infection control roles. As the pandemic evolved, many units adopted dynamic approaches to reinstate routine activity, leveraging teleconsultations, rapid point-of-care testing and streamlined pathways to mitigate backlog and minimise loss to follow-up. The global response has highlighted the importance of flexible operational models, continuous reassessment of infection risks and the integration of emerging evidence on gastrointestinal viral shedding into clinical workflows.
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Gastrointestinal Endoscopy Practices during the COVID-19 Pandemic publication trend
The graph below shows the total number of articles in gastrointestinal endoscopy practices during the covid-19 pandemic across all publications each year (not limited to Nature Index journals).
Technical terms
Gastrointestinal endoscopy: Visual examination of the digestive tract using a flexible endoscope.
Esophagogastroduodenoscopy (EGD): Endoscopic inspection of the oesophagus, stomach and duodenum.
Aerosol-generating procedure: Any clinical intervention that produces airborne particles capable of transmitting pathogens.
Personal protective equipment (PPE): Barriers such as masks, gowns, gloves and eye protection worn to reduce infection risk.
Negative-pressure room: An isolation space designed to contain airborne contaminants by ensuring airflow into, but not out of, the room.
References
- The Impact of the COVID-19 Pandemic on Gastrointestinal Endoscopy Activity in a Tertiary Care Center from Northeastern Romania. Healthcare (2021).
- Severe acute respiratory syndrome coronavirus 2 prevalence in saliva and gastric and intestinal fluid in patients undergoing gastrointestinal endoscopy in coronavirus disease 2019 endemic areas: Prospective cross‐sectional study in Japan. Digestive Endoscopy (2021).
- Gastrointestinal Endoscopy in the Era of COVID-19. Frontiers in Medicine (2020).
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