Evolution of International Pediatric Endoscopic Practice Changes During the Coronavirus Disease 2019 Pandemic

ABSTRACT Objectives: The coronavirus disease 2019 (COVID‐19) pandemic has drastically altered endoscopic practices. We initially reported the international impact of COVID‐19 on pediatric endoscopic practice. This follow‐up study aimed to assess changes 7 months following the initial survey to delineate practice change patterns as the pandemic evolved. Methods: Pediatric gastroenterologists who responded to the initial survey were re‐surveyed seven months later using Research Electronic Data Capture (REDCap). The survey recorded information on changes in pediatric endoscopic practice patterns, including COVID‐19 screening and testing processes and personal protective equipment (PPE) utilization. Additionally, endoscopists’ risk tolerance of COVID‐19 transmission was evaluated. Results: Seventy‐five unique institutions from 21 countries completed surveys from the 145 initial responses (51.7% response rate). Procedural volumes increased at most institutions (70.7%) and most were performing previously postponed cases (90.7%). Ninety‐seven percent of institutions were performing pre‐endoscopy screening with 78.7% testing all patients. Many institutions (34.7%) have performed procedures on COVID‐19 positive patients. There was significantly less PPE reuse (P < 0.05) and fewer institutions recommending full PPE for all endoscopies (43.2% vs 59.2%, P = 0.013). Overall, pediatric endoscopists’ risk tolerance of COVID‐19 transmission is low. Conclusions: This is the first survey to highlight the evolution of pediatric endoscopic practices related to the COVID‐19 pandemic, underscoring the need for ongoing pandemic‐related guidance for pediatric endoscopic practice.