Evaluation of patients undergoing emergency surgery in a COVID-19 pandemic hospital: a cross-sectional study

Abstract

BACKGROUND: The COVID-19 pandemic is threatening healthcare systems and hospital operations on a global scale. Treatment algorithms have changed in general surgery clinics, as in other medical disciplines providing emergency services, with greater changes seen especially in pandemic hospitals. OBJECTIVES: To evaluate the follow-up of patients undergoing emergency surgery in our hospital during the COVID-19 pandemic. DESIGN AND SETTING: Cross-sectional study conducted in a tertiary-level public hospital. METHODS: The emergency surgeries carried out between March 11 and April 2, 2020, in the general surgery clinic of a tertiary-care hospital that has also taken on the functions of a pandemic hospital, were retrospectively examined. RESULTS: A total of 25 patients were included, among whom 20 were discharged without event, one remained in the surgical intensive care unit, two are under follow-up by the surgery service and two died. Upon developing postoperative fever and shortness of breath, two patients underwent thoracic computed tomography (CT), although no characteristics indicating COVID-19 were found. The discharged patients had no COVID-19 positivity at follow-up. CONCLUSION: The data that we obtained were not surgical results from patients with COVID-19 infection. They were the results from emergency surgeries on patients who were not infected with COVID-19 but were in a hospital largely dealing with the pandemic. Analysis on the cases in this study showed that both the patients with emergency surgery and the patients with COVİD infection were successfully treated, without influencing each other, through appropriate isolation measures, although managed in the same hospital. In addition, these successful results were supported by 14-day follow-up after discharge.

Performing General Surgery Emergencies Safely during COVID-19 Outbreak

“…Besides, authors from many countries have reported their own experiences in emergency, unpostponable surgical procedures and interventions [5,10,14,15]. As Lima et al reported, all patients presenting to the emergency department with a presumed acute abdomen diagnosis were considered as having suspected COVID-19 even if they had no respiratory symptoms and/or fever [16].…”

“…From the first case to 11 May 2020, 139.771 cases have been diagnosed as of 11 March 2020, and 3841 deaths have been reported [9]. Approximately 60% of the total number of cases have been reported from Istanbul, where our hospital is located [10]. Our hospital has also been declared a pandemic hospital from the very first day of the pandemic.…”

Impact of COVID-19 on the outcomes of gastrointestinal surgery

“…In a Turkish study, 25 patients underwent emergency abdominal surgery from March to April 2020 in the COVID-19 era [37]. None of the patients had preoperative COVID-19, and two had suspected COVID-19.…”

Conservative management of acute appendicitis in the era of COVID 19: A multicenter prospective observational study at the United Arab Emirates

“…The overload of hospitals with COVID-19 patients resulted in changing priorities for the benefit of patients as well as health care providers [ 2 ]. Also, due to the nature of transmission of the COVID-19 that was found to spread during aerosol generating procedures (AGPs) including surgeries, many concerns were raised on infection control and safety on patients as well as health care providers' [ 3 , 4 ]. For that reason, changes in the management protocols and implementations of new guidelines along with novel practices were recommended with the aim of reducing the risk of infection as well as establishing more efficient use of the available resources.…”