Paediatric Gastrointestinal Procedural Patterns in New York City During the COVID-19 Pandemic

Aim

We evaluated changes in paediatric endoscopy patterns in New York City (NYC) before, during, and after the COVID-19 pandemic to see the effects on paediatric procedures, medical utilisation, and medical trainees over 4 years.

Methods

Clinical data on gastroenterology procedures performed on patients under 21 years old were collected from five NYC hospitals via the INSIGHT Clinical Research Network. We reviewed data from March to February for 4 years: 2019–2020 as baseline, 2020–2021 as the pandemic, and 2021–2022 and 2022–2023 as post-pandemic.

Results

A total of 40 218 paediatric GI procedures were performed on 18 362 patients. Yearly changes in procedures differed by subcategory, with a significant decrease in invasive procedures during the pandemic compared to the year prior: liver biopsies (43.3% decrease, 95% CI 26.4, 56.7), motility (26.0% decrease, 95% CI 2.89, 43.88), and suction rectal biopsies (48.6% decrease, 95% CI 5.7, 73.1). Urgent procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and foreign body removal continued at a similar rate during the pandemic. In the 2021–2022 post-pandemic year, overall paediatric GI procedures significantly increased by 33.0% (95% CI 19.1, 48.6) compared to pre-pandemic rates in 2019, and remained significantly increased in 2022 by 41.8% (95% CI 27.2, 58.2) compared to 2019. This trend was true for both urgent and non-urgent procedures.

Conclusion

During the COVID-19 pandemic, urgent procedures continued at similar rates. However, post-pandemic procedural volumes were higher than pre-pandemic numbers, suggesting the pandemic led to delays in paediatric endoscopic care.