The Impact of the COVID-19 Pandemic on Pediatric Endoscopy Practices: A Single-Center Experience

Aim: This study aimed to evaluate the impact of the Coronavirus disease 2019 (COVID-19) pandemic on pediatric endoscopy practice, focusing on changes in procedure volume, prioritization, and implementation. Additionally, safety approaches adopted in response to evolving clinical conditions during the pandemic were assessed.Materials and Methods: Children aged 0–18 years who underwent endoscopy at Gazi University Faculty of Medicine, Department of Pediatric Gastroenterology between March 2019 and February 2022 were retrospectively reviewed. The study period was divided into three phases: the one-year pre-pandemic period, the first year of the pandemic, and the second year of the pandemic. Endoscopy volume, indications, procedure types, and COVID-19–related practices were compared across these periods.Results: A total of 1,283 pediatric endoscopic procedures were analyzed, including 617 performed in the pre-pandemic period, 215 during the first pandemic year, and 451 during the second pandemic year. During this period, the proportion of procedures performed for urgent and very urgent indications increased, while elective procedures declined significantly (p = 0.0028). Despite the marked reduction in overall endoscopy volume, the relative proportions of diagnostic and interventional procedures remained stable across the study periods (p = 0.230). The overall diagnostic yield increased significantly during the first pandemic year compared with the pre-pandemic period (74.0% vs. 48.8%, p <0.001), likely reflecting both the predominance of indications with higher pre-test probability and the restriction of presentations to patients with more severe symptoms. In the second pandemic year, endoscopy volume increased markedly compared with the first year, and the distribution of indications shifted toward a profile closer to the pre-pandemic period. No confirmed SARS-CoV-2 transmission was detected among patients or healthcare workers following endoscopic procedures performed under infection control measures.Conclusions: The COVID-19 pandemic led to substantial reorganization of pediatric endoscopy practice. While procedure volumes declined and urgent indications predominated during the early phase of the pandemic, endoscopic activity gradually normalized as deferred procedures were rescheduled. Our findings suggest that pediatric endoscopy can be performed safely and sustainably during extraordinary conditions when appropriate prioritization and infection control measures are applied.