Mitigating surgical emergency practice during COVID-19 pandemic?


COD: 3_2021_15_3525 Categoria:

Noman Zafar*, Florence Kashora*, Kamran Qurashi*, Jasim Al-Musawi*, Josef Watfah*,
Lampros Liasis*, Manoj Sen*, Stuart Gould*, Carolynne J Vaizey**/***,
Janindra Warusavitarne**/***, Cosimo Alex Leo
Ann Ital Chir, 2021 92, 3: 312-316

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PURPOSE: To define the change in Emergency Surgical Unit (ESU) workload during the COVID-19 pandemic.
METHODS: Patient data for a three-week period was prospectively collected for ESU patients during lockdown period and compared to the ESU workload for the same time period prior to lockdown.
RESULTS: Surgical emergencies admissions reduced by 2.5 times during our study period (p value = 0.001). In this changed paradigm, the overall number of surgical emergencies were reduced. A high mortality (n = 4, 5.7%) was noted during lockdown period as compared to pre-lockdown period (n = 1, 0.58%, p value = 0.025). Almost half of surgical admissions were tested for COVID-19 based on their symptoms and more than third (n=14, 38.9%) of them were positive. Gastrointestinal symptoms were common in COVID-19 positive group (85.7%) and only a third (36%) of COVID-19 positive patients needed surgical attention. Chest x-ray findings were comparable to PCR testing in terms of
sensitivity and specificity but CT chest was more sensitive.
CONCLUSIONS: It remains unclear how COVID-19 reduced surgical emergencies. A significant proportion of COVID-19 presented with gastrointestinal symptoms. In a new outbreak all General Surgical patients should be tested with CRP and WCC used as a triage adjunct.