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The dramatic COVID 19 outbreak in Italy is responsible of a huge drop of urological surgical activity: a multicenter
Bernardo Rocco1, Maria Chiara Sighinolfi2, Marco Sandri3
1Urology Unit, University of Modena and Reggio Emilia, Modena, Italy.
Insights
The COVID-19 outbreak caused a 78% drop in Italian urology surgeries, with a 94% reduction in Lombardy. This surgical decline, especially in oncology, highlights the impact of healthcare system reorganisation during pandemics.
Area of Science:
- Urology
- Public Health
- Epidemiology
Background:
- The coronavirus disease 2019 (COVID-19) outbreak necessitated rapid reorganization of healthcare systems globally.
- Italy experienced a high COVID-19 fatality rate, leading to significant adjustments in medical services.
Purpose of the Study:
- To analyze the impact of the COVID-19 outbreak on surgical volumes within urology in Italy.
- To describe the trend in elective urological procedures during the pandemic's initial phase.
Main Methods:
- A survey was conducted among 33 urological units affiliated with the Italian Group for Advanced Laparo-Endoscopic Surgery (AGILE).
- Urologists reported weekly elective surgical procedure volumes from the pandemic's onset for one month.
Main Results:
- Overall weekly urological surgeries decreased by 78% from a baseline of 1213 procedures.
- Lombardy, an early COVID-19 epicenter, saw a 94% reduction in surgical activity.
- Oncological and non-oncological surgical activity declined by 35.9% and 89%, respectively, with a two-week delay in other regions.
Conclusions:
- The COVID-19 pandemic led to a substantial decline in Italian urological surgical activity.
- The reduction in surgical care, particularly for oncological cases, poses potential harm.
- Lessons learned from Italy's experience can inform future pandemic preparedness and surgical planning globally.
Objective:
To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID-19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID-19.
Methods:
A total of 33 urological units with physicians affiliated to the AGILE consortium (Italian Group for Advanced Laparo-Endoscopic Surgery; www.agilegroup.it) were surveyed. Urologists were asked to report the amount of surgical elective procedures week-by-week, from the beginning of the emergency to the following month.
Results:
The 33 hospitals involved in the study account overall for 22 945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed overall 1213 procedures/week, half of which were oncological. A month later, the number of surgeries had declined by 78%. Lombardy, the first region with positive COVID-19 cases, experienced a 94% reduction. The decrease in oncological and non-oncological surgical activity was 35.9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions.
Conclusion:
Italy, a country with a high fatality rate from COVID-19, experienced a sudden decline in surgical activity. This decline was inversely related to the increase in COVID-19 care, with potential harm particularly in the oncological field. The Italian experience may be helpful for future surgical pre-planning in other countries not so drastically affected by the disease to date.
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