Table 1.
Risk Stratification Tool for Endoscopy Scheduling During COVID-19
| Patient Factors | Points |
|---|---|
| Age, ya | |
| <60 | 0 |
| 60–69 | 1 |
| ≥70 | 2 |
| Comorbidityb | |
| No major comorbidity | 0 |
| Immunocompromised | 1 |
| Chronic lung disease | 1 |
| Chronic kidney disease, heart disease, cancer, hypertension, or diabetes | 1 |
| Procedure factors | |
| Screening | 4 |
| Low-risk surveillance (polyp, IBD, etc.) | 4 |
| Low-acuity diagnostic (eg, chronic abdominal pain, chronic diarrhea) | 3 |
| Moderate-acuity diagnostic (eg, FIT positive) | 2 |
| High-acuity diagnostic (eg, red-flag symptoms, abnormal imaging) | 0 |
| Therapeutic indication (eg, acute bleeding) | 0 |
| Endoscopy stratification | Total Score |
| Consider deferral of endoscopy | >3 |
| Consider scheduling endoscopy | ≤3 |
COVID-19, coronavirus disease 2019; FIT, fecal immunochemical testing; IBD, inflammatory bowel disease.
Based on World Health Organization (WHO) reports of highest risk individuals,6 individuals at highest risk for severe disease and death include people aged over 60 years and those with underlying conditions such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease, and cancer….Case fatality rate (CFR) increases with age, with the highest mortality among people over 80 years of age (CFR, 21.9%).
Based on the WHO reports of highest risk groups,6 “Patients who reported no comorbid conditions had a CFR of 1.4%, patients with comorbid conditions had much higher rates: 13.2% for those with cardiovascular disease, 9.2% for diabetes, 8.4% for hypertension, 8.0% for chronic respiratory disease, and 7.6% for cancer.”