The COVID-19 Pandemic and the Surgical Workload of the UPR-affiliated Hospitals

To evaluate how the COVID-19 pandemic (declared in March 2020) affected our surgical workload.

Using the University of Puerto Rico Department of Surgery database, we evaluated the number of surgical cases and their characteristics for the years 2019 through 2021. The variables examined included age, sex, American Society of Anesthesiology classification, type of surgery (elective/emergency), whether the patient had been admitted or was an outpatient, and outcome.

The total number of surgical cases decreased 30%, falling from 5,040 in 2019 to 3,564 in 2020, but then increasing about 10% to 3,935 in 2021. The number of elective surgery cases dropped 33%, going from 4,383 in 2019 to 2,924 in 2020. The number of emergency surgeries had a minor decrease of 16%, diminishing from 650 to 546 between 2019 and 2020, inclusive. Patients undergoing elective surgery during 2020 were found to be older, were more frequently men, and required inpatient admission more often. Three significant periods were identified and correlated to the number of surgical cases, the first being the COVID-19 lockdown (March 2020) and the second and third being the increases in infections caused by the Delta and Omicron variants of the virus (July 2021 and December 2021, respectively).

The COVID-19 pandemic resulted in a significant decrease in the number of surgical cases. Two years after the pandemic, we have not recovered and continue to have fewer surgical cases than we did in 2019.