Introduction:

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection has diverse gastrointestinal manifestations, often requiring endoscopy.

Objective:

The primary objective is to describe the need for endoscopic procedures from a sample of hospitalized patients with moderate to severe coronavirus disease 2019 (COVID-19). The secondary objective is to describe the characteristics, findings, and interventions.

Materials and methods:

An observational, descriptive, cross-sectional study was conducted from May 2020 to December 2021 about indications, endoscopic findings, interventions, anesthesia requirements, and adverse events from a sample of patients with moderate to severe COVID-19 in whom gastrointestinal endoscopic procedures were performed for any indication.

Results:

Of 2,312 hospitalized patients with moderate to severe COVID-19, 2.72% required endoscopic procedures, with a predominance of men (75%), an average age of 65.7 years, and the majority for upper gastrointestinal endoscopy (68%). The most frequent indications were gastrointestinal bleeding (62%) and enteral access (28.3%). An ischemic compromise was documented in three patients. Of those with digestive bleeding, 9.5% required hemostatic therapy, and 65% were on ventilatory support and sedation during the endoscopic procedure. In half of these cases, anesthesiology support was required without periprocedural adverse events, nor was a negative pressure room required in any procedure.

Conclusions:

In patients with moderate to severe COVID-19 requiring gastrointestinal endoscopy, clinical judgment is necessary to define the relevance of the procedure; in many cases, conservative management may be considered.

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