Effect of the COVID-19 pandemic on non-COVID-19 patients admitted from the emergency department to the surgical ward during the strict phase of the pandemic in Buenos Aires. A cohort study

Abstract

Background: Emergency general surgery conditions require immediate evaluation and timely resolution, even during quarantine.
Objective: to analyze variations in admissions, surgical outcomes and severity of the disease in non-COVID-19 emergency admissions during the first months of the pandemic. Secondary objectives, to performed a sub-analysis of common surgical conditions, as appendicitis, biliary tract disease, diverticulitis and complicated tumors.
Material and methods: An observational, ambispective study was carried out on a prospective cohort of patients who consulted with on-call surgical pathology and required hospitalization from March 20th, 2020 until July 31, 2020 referred to as Pandemic Group (PG), analyzed and compared with the same period of 2019, Control Group (CG).
Results: We experienced an increase in the number of patients admitted at the ED during the pandemic PG vs CG (346 versus 305, p 0.157). Patients in the PG were found to be significantly more ill (58.1% versus 48,8%, p 0.018). A significant delay was found globally in both, time from onset of symptoms presentation to consultation (48 hours versus 24 hours, p < 0.001), and time from diagnosis to surgery (23 hours versus 7 hours, p < 0.001) in the PG, and an increase in the mean operative time (75 versus 60 minutes, p= 0,001). There was no significant difference in postoperative complications.
Conclusion: During the pandemic we observed an increase in urgent surgical procedures due to biliary pathology and gastrointestinal tumors. The patients consulted with more advanced stages of disease, but this had no impact on postoperative morbidity or mortality,