Endoscopy Challenges During the SARS-CoV- 2 Pandemic: A Single-Center Experience from Cairo University Hospital-Egypt

Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on the daily practice of gastrointestinal endoscopy all over the world. Most endoscopy units had to undergo major adjustments including reducing the numbers of personnel, trainees and postponing a large proportion of endoscopic procedures. We hereby report the daily experience from 15th of March to 15th of July 2020 of Kasr Al Ainy Cairo University Hospital Endoscopy unit during the COVID-19 pandemic pre-peak and peak phases in Egypt. Aim of Study: To study the implications of COVID-19 on the endoscopy unit daily practice and exhibiting the precautions adopted to minimize the risk of exposure to infection. Patients and Methods: We retrospectively analysed the number of procedures done during the peak of the 1st wave of COVID-19 pandemic in Egypt as well as precautions used in the endoscopy setting and a comparison was made with the number of procedures done over the previous 4 months and during the same period in 2019. Results: During the lockdown, upper endoscopies and colonoscopies accounted for the major differences in number of procedures in comparison to the previous four months prior to the lockdown. On the other hand, the rate of endoscopic biliary drainage did not differ significantly. Conclusion: During the global COVID-19 pandemic, reorganization of the workflow and the service provided by Kasr Al-Ainy Cairo University hospital endoscopy unit was deemed necessary. Through implementation of strategies aiming at proper patient selection and risk assessment, effi-ciently reducing the number of working staff, putting off training programs, and applying strict infection control meas-ures, we were able to safely traverse the peak phase of the pandemic in Egypt.