The dramatic COVID 19 outbreak in Italy is responsible of a huge drop of urological surgical activity: a multicenter observational study

Rocco, Bernardo; Sighinolfi, Maria Chiara; Sandri, Marco; Altieri, Vincenzo; Amenta, Michele; Annino, Filippo; Antonelli, Alessandro; Baio, Raffaele; Bertolo, Riccardo; Bocciardi, AldoMassimo; Borghesi, Marco; Bove, Pierluigi; Bozzini, Giorgio; Brunocilla, Eugenio; Cacciamani, Giovanni; Calori, Alberto; Cafarelli, Angelo; Celia, Antonio; Carbone, Antonio; Cocci, Andrea; Corsaro, Alfio; Costa, Giovanni; Ceruti, C.; Cindolo, Luca; Crivellaro, Simone; Dalpiaz, Orietta; D’Agostino, Daniele; Dall'Oglio, B.; Dente, D.; Falabella, R.; Falsaperla, Mario; Ferrari, Giovanni; Finocchiaro, Marinella; Flammia, Rocco Simone; Gaboardi, Franco; Galfano, Antonio; Gallo, Fabrizio; Gatti, Lorenzo; Greco, Francesco; Khorrami, Sada; Leonardo, Costantino; Marenghi, Carlo; Nucciotti, R.; Oderda, Marco; Pagliarulo, Vincenzo; Parma, P.; Pastore, Antonio Luigi; Pini, G.; Porreca, Angelo; Pucci, Luigi; Schenone, Maurizio; Schiavina, Riccardo; Sciorio, Carmine; Spirito, Lorenzo; Tafuri, Alessandro; Terrone, Carlo; Umari, Paolo; Varca, Virginia; Veneziano, Domenico; Verze, Paolo; Volpe, Alessandro; Micali, Salvatore; Berti, Lorenzo; Zaramella, S.; Zegna, Luisa; Bertellini, Elisabetta; Minervini, Andrea

doi:10.1111/bju.15149

Cited by 37 publications

(40 citation statements)

References 8 publications

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“…[15] Studies from Italy documented similar 70-78% reduction in elective urological and oncological surgeries, our study has documented an effect of similar magnitude (91%) on elective surgeries as documented from Italy. [11,20] Caesarean sections were affected the least of all emergency surgeries (29.7%) as shown in Fig. 3, documenting that redistribution of priorities happened even within the emergency surgery category.…”

Section: Discussionmentioning

confidence: 85%

“…An extensive body of literature has dealt with practice guidelines, prioritisation and resource managements in pandemic in subspecialties like surgical oncology, urology, minimal access surgery, otolaryngology, neurosurgery amongst others. [4,6,9,10,11] Few studies have quanti ed the effect of COVID-19 pandemic on the emergency surgeries. Hence, we aimed to quantify the reduction in the emergency surgeries and bellwether procedures as an effect of COVID-19 pandemic and subsequent lockdown, across many hospitals in India.…”

Section: Introductionmentioning

confidence: 99%

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Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

Gadgil¹,

Bhandoria²,

Khajanchi³

et al. 2020

Preprint

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Background The ongoing COVID-19 pandemic and subsequent lockdown have adversely affected global health care services to varying extent. Emergency Services were also affected along with elective surgeries, which were deferred to accommodate the added burden of COVID 19 affected patients, on the healthcare systems. We aimed to assess the change in delivery of essential and emergency surgeries due to the pandemic.Methodology A research consortium led by WHO Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in Low- and Middle-Income countries (LMIC), India, conducted this retrospective cross-sectional study with 12 recruited centers. All surgeries performed during the months of April 2020 were compared with those performed in April 2019. These surgeries were stratified into emergency and elective, and further categorized based on NHS surgery prioritization documents. Results A total of 4396 surgeries were performed at these centers in April 2019 and 1216 surgeries were performed in same month during 2020, yielding a fall of 72.3% (1216 /4396).We found a 54% reduction in emergency surgeries and a 91% reduction in the elective surgeries. Number of cesarean sections reduced by 29.7% and fracture surgeries declined by 85.3% Laparotomies and surgeries for local soft tissue infections with necrotic tissue reduced by 71.7% and 69.5% respectively.Conclusion Our study quantifies the effects of COVID 19 pandemic on surgical care delivery in India and documents that the overall surgical volume reduced by three fourths in the pandemic period. Emergency surgeries reduced to half when compared with pre-pandemic period. Cesarean section surgeries were affected the least by pandemic, whereas the fracture surgeries and laparotomies were affected the most.

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Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

Gadgil¹,

Bhandoria²,

Khajanchi³

et al. 2020

Preprint

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“…During the COVID-19 pandemic common cancellations and rescheduling significantly extends this process [ 14 ]. In Italy, the European country with the highest number of confirmed COVID-19 cases, the observed decrease in urological oncological and non-oncological surgical activity was 35.9% and 89%, respectively [ 15 ]. The reorganization of surgical procedures has promoted the onset of a novel factor influencing the attempt to normalize surgical planning, namely the fear to contract COVID-19.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and the urological practice: changes and future perspectives

Nowak

Krajewski

Kiełb

et al. 2020

Cent european J Urol

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Introduction The COVID-19 pandemic has brought great challenges to the management of urological patients. Like most surgical specialties, urology has shifted towards an emergency mentality. Currently, the beginning of the de-escalation phase of the pandemic has been observed, which will certainly pose new challenges to the urological community. Material and methods A non-systematic search was conducted through the Medline and Web of Science databases. The main keywords used in the search were: ‘COVID-19’, ‘SARS-CoV-2’, ‘urology’. The search included articles without time and language limitation. Results During the peak of the COVID-19 pandemic urological services had to focus on maintaining urgent-oncological and emergency-trauma procedures. First adapted recommendations were released at the end of March 2020. Primarily, they included information regarding the prioritization of surgical procedures. Currently, the beginning of the de-escalation phase in many countries has forced the necessity of establishing new degrees of priority for surgical interventions. During the COVID-19 pandemic, cancellations and rescheduling significantly extend the waiting time for outpatient appointments and surgical procedures. A network of expert high-volume centres, at every level of referentiality, should guarantee the continuity of oncological care, supported with telemedicine systems. The COVID-19 pandemic has caused a substantial decrease in clinical activity of urology residents. There also is huge potential for remote technology to address and improve education and training continuation in this field. Conclusions Urological care has been severely impaired by the COVID-19 pandemic. Urologists must adapt to the dynamically changing reality, prioritizing the safety and well-being of their patients and their clinic workforce.

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“…As a result, the volume of elective procedures dramatically dropped: this occurrence applied either to diagnostics, such as gastro-intestinal, and to scheduled surgical interventions. 1 , 2 , 3 …”

mentioning

confidence: 99%

“…A similar trend is extending progressively to other cities and regions, due to the need for an extra-care availability for COVID-19 patients. 3 …”

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confidence: 99%

Planning of surgical activity in the COVID-19 era: A proposal for a step toward a possible healthcare organization

et al. 2020

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Health-care systems worldwide are experiencing a decline in elective surgical activity during the current COVID-19 pandemics. The progression of morbid conditions—especially of cancer—and the uncontained increase of waiting list for scheduled interventions are the major drawbacks. We propose a possible organization of a COVID-19 free hospital or hub, that include both patients’ and workforce’s preparation before entering the facility. The addition of a planned pathway for the whole workforce (physicians, nurses, cleaning and transporting crews, etc.) represents the basis of the program, and involves COVID-19 testing and subsequent self-isolation before entering the hospital, avoidance of work in non-COVID free areas, a strategic fractioning with a multilayer coverage system of care, periodic re-testing. Based on these suggestions, the realization of a COVID-19 free hospital could be achieved, allowing the continuation of a safe surgical activity in view of a possible restoration of non-urgent activity.

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The dramatic COVID 19 outbreak in Italy is responsible of a huge drop of urological surgical activity: a multicenter observational study

Abstract: To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID-19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID-19.

Cited by 37 publications

References 8 publications

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

COVID-19 and the urological practice: changes and future perspectives

Planning of surgical activity in the COVID-19 era: A proposal for a step toward a possible healthcare organization

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The dramatic COVID 19 outbreak in Italy is responsible of a huge drop of urological surgical activity: a multicenter observational study

Abstract: To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID-19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID-19.

Cited by 37 publications

References 8 publications

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter&nbsp;Cross-Sectional Study

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter&nbsp;Cross-Sectional Study

COVID-19 and the urological practice: changes and future perspectives

Planning of surgical activity in the COVID-19 era: A proposal for a step toward a possible healthcare organization

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Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study

Understanding the Effect of COVID-19 Pandemic on Emergency Surgical Care Delivery in India: A Multicenter Cross-Sectional Study