Video capsule endoscopy safe for evaluating GI bleeding during COVID-19
Video capsule endoscopy is a safe alternative to standard diagnostic evaluation of hematemesis and non-hematemesis during the COVID-19 pandemic, according to a presenter at the American College of Gastroenterology virtual annual meeting.
“A [video capsule endoscopy]-first strategy reduces the risk of exposure of staff to endoscopic aerosols, converses personal protective equipment and reduces staff utilziation,” Shahrad Hakimian, MD, from the University of Massachusetts Medical Center in Worcester, said.
From March through May 2020, Hakimian and colleagues analyzed data from 50 patients with GI bleeding or severe anemia who underwent a video capsule endoscopy as part of an experimental group. They compared data with that from 57 historical patients evaluated for GI bleeding with standard of care prior to the COVID-19 era as controls. Researchers used Fisher’s exact test to compare categorical variables.
More patients in the experimental group presented with melena; however, fewer patients presented with hematochezia as a manifestation of their GI bleeding.
According to researchers, when using the first diagnostic modality, bleeding could be localized in 38 patients from the COVID-19 cohort vs. 36 historical control patients (P > .05). Twenty-two patients underwent VCE and need additional invasive diagnostic and therapeutic maneuvers. But most patients were spared more invasive testing. Thirteen patients who underwent video capsule endoscopy and 47 control patients later underwent upper endoscopy for the assessment of GI bleeding.
Hakimian reported transfusion requirements, degree of hemoglobin drop, in-hospital mortality, re-admission or rebleeding rates were not significantly different between the groups.
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Hakimian S, et al. Abstract S0590. Presented at: The American College of Gastroenterology Annual Scientific Meeting (Virtual). Oct. 23-28, 2020.
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