The Impact of SARS CoV-2 (Covid-19) on emergency surgical procedures

A six month comparative study in a Single centre Medical College Hospital in South Kashmir.

Abstrakt

Aim:  In our study, the number and nature of emergency cases were compared pre and post six months from the date Covid 19 was declared globally pandemic.

Materials and Methods: This is a retrospective observational study in which the number and nature of cases were collected from the data maintained in the operation theatre. Records of emergency procedures were compiled from September 15th 2019, to March 15th 2020 (Pre Covid 19) and from March 15th 2020, to September 15th 2020. The number and nature of cases in each month were analyzed and followed with the national and local graph of Covid 19 instances. Further patient clinical history was collected from case sheets. Socio-demographic information was collected from the patients and attendants randomly. The data of surgeries was compared as PreCovid and Post Covid era, and Regression statistics using the ANOVA method was used.

Results: Among all the emergency surgeries, emergency appendicectomies had a striking impact. The number of appendicectomies in the Covid 19 era was far less as compared to six months pre-Covid 19 eras (63 vs 166, p <0.006)). Laparotomies for different indications like peritonitis, hemoperitoneum, intestinal obstruction, and liver abscess, etc., were also less but not that significant (40 vs 47). Covid -19 infection was not encountered in any patient or health worker after surgical interventions.

Conclusions: After the declaration of Covid 19 as a global pandemic, the number of emergency surgical procedures decreased significantly. However, those patients who needed immediate surgical intervention were treated as per the standard treatment guidelines before the pandemic. Furthermore, a good number of patients whose surgery could be deferred due to lockdown or lack of infrastructure and human resources were managed conservatively without any significant mortality and morbidity.

Clinical significance: If the necessary precautions, isolations, and algorithms are followed, the emergency procedures in COVID 19 process can be done with the same zeal and outcome using limited resources, both human and infrastructure.