Emergency Surgery in Suspected COVID-19 Patients With Acute Abdomen

Gao, Yunhe; Xi, Hongqing; Lin, Chen

doi:10.1097/sla.0000000000003961

Cited by 64 publications

(79 citation statements)

References 6 publications

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“…According to a serological study about immunity against COVID developed by the Spanish Government, 11.4% of Madrid population have immunoglobulins against COVID [12], which could represent over 600.000 cases. The effect of COVID pandemic on emergency surgery has been a subject of analysis in several studies [13][14][15][16]. The results of the PIACO study are consistent with other studies in the current literature.…”

Section: Change In Epidemiological Patternsupporting

confidence: 78%

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Guadalajara

Nova

Gonzalez

et al. 2020

Preprint

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BackgroundAnecdotal evidence suggests that community infection control measures during the COVID-19 outbreak have modified the number and natural history of acute surgical inflammatory processes (ASIP - appendicitis, cholecystitis, diverticulitis and perianal abscesses) admissions. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation and treatment ASIP and quantify the effect of COVID-19 infection on the outcomes of ASIP patients. MethodsThis was a multicentre, comparative study, whereby ASIP cases from March 14th to May 2nd 2019 acted as historical controls for the cohort of patients with the same pathology during the COVID-19 pandemic. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain).ResultsThe number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020. This reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. ConclusionsThe number of ASIP cases treated during the pandemic was reduced by more than one third mainly due to a dramatic reduction in mild cases. This also has represented a selection of severe cases. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances.The positive COVID-19 status itself did not have a direct impact on either morbidity or mortality. This is an interesting finding which if confirmed through future research with a larger sample size of COVID-19 positive patients, can expedite the recovery phase of acute surgical services.

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Section: Change In Epidemiological Patternsupporting

confidence: 78%

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Guadalajara

Nova

Gonzalez

et al. 2020

Preprint

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“…The characteristics of included trials were presented in Table 1 . A total of 269 patients from 47 studies [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 [95% CI, 42.49; 59.34], and 49% [95% CI, 0.33, 0.65] patients were female.…”

Section: Resultsmentioning

confidence: 99%

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Wang¹,

Wu²,

Xu³

et al. 2020

EClinicalMedicine

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Background The 2019 novel coronavirus disease (COVID-19) can complicate the perioperative course to increase postoperative mortality in operative patients, and also is a serious threat to medical staff. However, studies summarizing the impact of COVID-19 on the perioperative mortality of patients and on the safety of medical staff are lacking. Methods We searched PubMed, Cochrane Library, Embase and Chinese database National Knowledge Infrastructure (CNKI) with the search terms “COVID-19″ or “SARS-CoV-2″ and “Surgery” or “Operation” for all published articles on COVID-19 from December 1, 2019 to October 5, 2020. Findings A total of 269 patients from 47 studies were included in our meta-analysis. The mean age of operative patients with COVID-19 was 50.91 years, and 49% were female. A total of 28 patients were deceased, with the overall mortality of 6%. All deceased patients had postoperative complications associated with operation or COVID-19, including respiratory failure, acute respiratory distress syndrome (ARDS), short of breath, dyspnea, fever, cough, fatigue or myalgia, cardiopulmonary system, shock/infection, acute kidney injury and severe lymphopenia. Patients who presented any or more of the symptoms of respiratory failure, ARDS, short of breath and dyspnea after operation were associated with significantly higher mortality ( r = 0.891, p < 0.001), while patients whose symptoms were presented as fever, cough, fatigue or myalgia only demonstrated marginally significant association with postoperative mortality ( r = 0.675, p = 0.023). Twenty studies reported the information of medical staff infection, and a total of 38 medical staff were infected, and medical staff who used biosafety level 3 (BSL-3) protective equipment did not get infected. Interpretation COVID-19 patients, in particular those with severe respiratory complications, may have high postoperative mortality. Medical staff in close contact with infected patients is suggested to take high level personal protective equipment (PPE). Funding Heilongjiang postdoctoral scientific research developmental fund and the National Natural Science Foundation of China.

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“…Este razonamiento se debe a la comunicació n de pé simos resultados postoperatorios en pacientes programados cuya extrapolació n al paciente urgente es compleja 24 . Por otro lado, tambié n existen series cortas con resultados aceptables en casos emergentes complicados en los que se mantuvo la indicació n quirú rgica 25 . La propia agresió n quirú rgica podría ser un desencadenante de una respuesta inflamatoria inmediata desproporcionada 26 que en pacientes infectados podría ser deleté rea; sin embargo, en el paciente urgente esa respuesta inespecífica ya está presente y la intervenció n supone (especialmente en cuadros infecciosos) la mejor manera de empezar a mitigarla.…”

Section: Implicaciones Sobre Las Indicaciones Habituales En Cirugía Dunclassified

Atención de la urgencia quirúrgica durante la pandemia COVID-19. Recomendaciones de la Asociación Española de Cirujanos

et al. 2020

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Emergency Surgery in Suspected COVID-19 Patients With Acute Abdomen

Cited by 64 publications

References 6 publications

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

How COVID changed surgical acute inflammatory diseases and surgeons clinical practice during the first wave of COVID-19

Factors affecting the mortality of patients with COVID-19 undergoing surgery and the safety of medical staff: A systematic review and meta-analysis

Atención de la urgencia quirúrgica durante la pandemia COVID-19. Recomendaciones de la Asociación Española de Cirujanos

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