Triage policy to postpone endoscopy for patients with low-risk varices is safe during the lockdown period of COVID-19 pandemic.

Publication date: Jul 12, 2023

During the COVID-19 pandemic, most of the endoscopic services were electively postponed or suspended. We aimed to assess the safety of a triage policy in patients receiving esophageal variceal ligation during the COVID-19 pandemic. Triage policy of endoscopic variceal ligation (EVL) was implemented in our hospital during the lockdown period from 15th May 2021 to 26th July 2021. One experienced gastroenterologist reviewed the prior-scheduled list of patients for the EVL prophylaxisprogram. We compared the clinical characteristics and outcomes with those receiving endoscopy due to esophageal varices from 17th May 2020 to 28th July 2020. Of the 124 patients receiving EVL, a higher percentage of esophageal variceal bleeding (EVB) was noted (9/32, 28. 1% vs. 8/92, 8. 7%, p = 0. 006) during the lockdown period, with a higher percentage of EVB in the referrals (7/9, 77. 8% vs. 2/14, 14. 2%, p = 0. 007). Among patients who received prophylactic EVL, 6 of 78 (7. 7%) experienced EVB during the normal period, which is no different to 2 of 23 (8. 7%) during the lockdown period. Twenty-three patients whose endoscopies were postponed by triage policy due to low-risk or eradicated varices did not experience EVB during the lockdown period. Child-Turcotte-Pugh (CTP) class C was predictive of EVB (relative risk 8. 400, P = 0. 033), entering the program of prophylactic EVL was the protective factor of EVB (relative risk 0. 016, P = 0. 002). Entrance into the prophylaxis program does not only decreases risk of EVB but also fosters comprehensive triage to postpone endoscopy during the lockdown period.

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Concepts Keywords
Endoscopies COVID-19
Gastroenterologist Esophageal varices
July Triage policy


Type Source Name
disease MESH varices
disease MESH COVID-19 pandemic
disease MESH esophageal varices
disease MESH bleeding
pathway REACTOME Reproduction
drug DRUGBANK Saquinavir
disease MESH syndrome
disease MESH infection
disease MESH gastrointestinal tract cancer
disease MESH gastrointestinal disorders
disease MESH Portal hypertension
disease MESH liver cirrhosis
disease MESH Liver Diseases
drug DRUGBANK Albendazole
drug DRUGBANK Serine
disease VO time
disease MESH hepatocellular carcinoma
pathway KEGG Hepatocellular carcinoma
disease MESH malignancies
disease IDO blood
drug DRUGBANK Human Serum Albumin
disease VO USA
disease MESH hepatitis
drug DRUGBANK Ethanol
disease VO volume
drug DRUGBANK Hepatitis B Vaccine (Recombinant)
disease MESH emergency
drug DRUGBANK Cysteamine
drug DRUGBANK L-Alanine
drug DRUGBANK Trestolone
disease MESH Alcoholism
pathway KEGG Alcoholism
disease MESH cirrhosis
disease VO effectiveness
disease VO effective

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