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The Impact of COVID-19 pandemic on pediatric surgery practice: A cross-sectional study
Gunadi1, Yofizal Idham1, Vincentia Meta Widya Paramita1
1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
Insights
The COVID-19 pandemic significantly reduced pediatric elective surgeries and outpatient services. Emergency pediatric surgery volumes remained stable, highlighting the need for strategies to manage delayed care and potential morbidity.
Area of Science:
- Pediatric Surgery
- Public Health
- Infectious Diseases
Background:
- The COVID-19 pandemic disrupted routine healthcare, impacting pediatric surgery services globally.
- Assessing the pandemic's effect on surgical practices is crucial for patient care continuity.
- Understanding changes in pediatric surgical procedures and outpatient services is vital.
Purpose of the Study:
- To compare pediatric surgery practices before and during the COVID-19 pandemic.
- To analyze changes in the volume and types of elective and emergency surgeries.
- To evaluate the impact on pediatric outpatient surgical services.
Main Methods:
- Retrospective comparison of pediatric surgery data.
- Data collected for a one-year period before the pandemic (March 2019-February 2020).
- Data collected for a three-month period during the pandemic (March-May 2020).
Main Results:
- Elective pediatric surgeries decreased significantly across various subspecialties (digestive, neonate, urology, oncology).
- No laparoscopic procedures were performed during the pandemic, compared to 16 cases pre-pandemic.
- Emergency pediatric procedures showed similar frequencies, while outpatient services declined.
Conclusions:
- Pediatric surgery practices, particularly elective and outpatient services, were severely affected by the COVID-19 pandemic.
- A strategic approach is needed to address morbidity from delayed elective surgeries.
- Balancing COVID-19 cross-infection risks with the benefits of elective procedures is essential.
Background:
Since the COVID-19 pandemic was declared by the World Health Organization on March 11, 2020, routine clinical practices were affected, including pediatric surgery services. We aimed to compare pediatric surgery practices, including the number and types of surgery, either elective or emergency surgeries and outpatient services, before the outbreak and during the COVID-19 pandemic in our institution.
Material And Methods:
We retrospectively compared pediatric surgery practices, including elective and emergency surgeries, and outpatient services between the previous one-year period (March 2019-February 2020), the last three months of that period (December 2019-February 2020) before the outbreak, and the three months (March-May 2020) during the COVID-19 pandemic in our hospital.
Results:
The frequency of elective surgeries during the pandemic was lower than during the last three months before the outbreak: 61 vs. 18 (~3-fold), 19 vs. 13 (~1.5-fold), 19 vs. 5 (~4-fold), and 30 vs. 15 (~2-fold) for digestive, neonate, urology and oncology cases, respectively. No laparoscopic procedures were performed during the pandemic compared with the one-year period before the outbreak (0 vs. 16 cases). The frequency of all emergency pediatric procedures before and during the COVID-19 pandemic was similar (29 vs. 20 cases, respectively). Moreover, a declining trend was also clearly apparent in the outpatient services during the pandemic compared with before the outbreak, both in the new and the established patients.
Conclusions:
The pediatric surgery practices in our institution have been severely affected by the COVID-19 pandemic, including elective and outpatient services. This setback needs a comprehensive strategy to avoid morbidity from the neglected elective surgeries during the pandemic, including the proper comparison between the real risk of COVID-19 cross-infection and the benefits of elective procedures.
