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Mitigating surgical emergency practice during COVID-19 pandemic?
Annali Italiani Di Chirurgia
|July 1, 2021
Summary
The COVID-19 pandemic significantly reduced emergency surgical unit admissions by 2.5 times, with a notable increase in mortality among admitted patients. Many COVID-19 patients presented with gastrointestinal symptoms, impacting surgical workload.
Area of Science:
- Medicine
- Surgery
- Infectious Diseases
Background:
- The COVID-19 pandemic caused widespread disruption to healthcare systems globally.
- Emergency surgical services experienced significant changes in patient presentation and workload.
- Understanding these changes is crucial for adapting surgical care during pandemics.
Purpose of the Study:
- To quantify the alteration in workload within the Emergency Surgical Unit (ESU) during the COVID-19 pandemic.
- To analyze the characteristics and outcomes of surgical emergencies during the lockdown period.
Main Methods:
- Prospective data collection of ESU patients over a three-week period during lockdown.
- Comparison of ESU workload data with the same period preceding the lockdown.
- Analysis of patient demographics, COVID-19 testing, symptoms, and outcomes.
Main Results:
- Surgical emergency admissions decreased by 2.5 times (p=0.001) during the lockdown.
- A significant increase in mortality was observed during lockdown (5.7%) compared to pre-lockdown (0.58%, p=0.025).
- Gastrointestinal symptoms were prevalent in COVID-19 positive patients (85.7%), with only 36% requiring surgical intervention. CT chest imaging showed higher sensitivity for COVID-19 detection.
Conclusions:
- The mechanisms by which COVID-19 reduced surgical emergencies remain to be fully elucidated.
- A substantial number of COVID-19 cases presented with gastrointestinal manifestations.
- Recommendations include universal COVID-19 testing for general surgical patients during outbreaks, utilizing CRP and WCC as triage aids.
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