Impact of COVID-19 on Emergency General Surgery

Introduction: there are limited data on emergency surgical practices during the covid-19 era. to compare the outcomes of emergency surgery before and during covid-19. methods: this was a retrospective study of emergency admissions to one general surgery department during november 2019, which is likely to represent our normal working pattern, and april 2020, which was the peak of the covid-19 crisis in our population. data of each of these two months were collected separately. the patients’ demographic features, type of procedures, blood test results, procedure approach (open; laparoscopic), morbidities and mortality were recorded. statistical analysis was performed using descriptive statistics, the chi-squared test, and the z-test. p-values <0.05 marked significance with a confidence interval of 95%. both groups underwent emergency surgery admissions and or operations. the primary endpoints were covid-19 diagnosis rates together with the number and types of surgical admissions and procedures. the secondary endpoints were complications, mortality, laparoscopic and open approaches, c-reactive protein (crp) levels and white blood cell counts, length of stay, age, and gender. results: a total of 332 patients were admitted; 146 patients during april 2020 and 177 during november 2019. there were 147 males and 176 females. the mean age was 51 years in the november group and 49 years in the april group. there were 146 procedures performed in november, while 117 operations were conducted in april. length of stay was 5.87 and 5.43 for november and april patients, respectively. there were 7 patients who tested positive for covid-19, and 3 mortalities occurred in each group. the crp level and prevalence of acute cholecystitis, abscess, and diverticulitis were significantly different between the two groups (p<0.05). meaningful differences were also found in the total number of operations, postoperative complications, and mortality (p<0.05). conclusion: postoperative complications, mortality, and acute cholecystitis occurred at significantly higher rates while abscess and diverticulitis were significantly less prevalent in the covid-19 era.