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. 2021 Oct 4;11(1):19645.
doi: 10.1038/s41598-021-98878-w.

The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies

H Guadalajara  1 , J L Muñoz de Nova  2 , M Yiasemidou  3 , M Recarte Rico  4 , L D Juez  5 , J García Septiem  2 , P Galindo Jara  6 , M García Virosta  7 , E Lobo Martínez  5 , E Martín-Pérez  2 , S Fernandez Gonzalez  8 , O Lopez-Fernandez  8 , D García-Olmo  8 ; PIACO Collaboration Group
Collaborators, Affiliations

The SARS-CoV-2 first wave impact in the acute inflammatory surgical pathologies

H Guadalajara et al. Sci Rep. .

Abstract

Anecdotal 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. This was a multicentre, comparative study, whereby ASIP cases from 2019, 2020 and 2021 (March 14th to May 2nd) were analyzed. Data regarding patient and disease characteristics as well as outcomes, were collected from sixteen centres in Madrid, and one in Seville (Spain). The number of patients treated for ASIP in 2019 was 822 compared to 521 in 2020 and 835 in 2021. This 1/3rd reduction occurs mainly in patients with mild cases, while the number of severe cases was similar. Surgical standards suffered a step back during the first wave: Lower laparoscopic approach and longer length of stay. We also found a more conservative approach to the patients this year, non-justified by clinical circumstances. Luckily these standards improved again in 2021. The positive COVID-19 status itself did not have a direct impact on mortality. Strikingly, none of the 33 surgically treated COVID positive patients during both years died postoperatively. 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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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study timeline comparing daily number of patients of 2020 with 2019 and the number of COVID-19 cases diagnosed each day (This data refers to the Community of Madrid only). COVID-19 coronavirus disease 2019.
Figure 2
Figure 2
Dispersion diagram of daily difference in number of ASIP within 2019 and 2020 and the number of COVID-19 cases (Community of Madrid data only). ASIP appendicitis, cholecystitis, diverticulitis and perianal abscesses, COVID-19 coronavirus disease 2019.
Figure 3
Figure 3
Relation between daily COVID and ASIP cases in 2021.
See this image and copyright information in PMC

References

    1. Brethauer SA, Poulose BK, Needleman BJ, et al. Redesigning a department of surgery during the COVID-19 pandemic. J. Gastrointest. Surg. 2020 doi: 10.1007/s11605-020-04608-4. - DOI - PMC - PubMed
    1. Collard M, Lakkis Z, Loriau J, et al. Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: Changes in treatment modalities related to the COVID-19 health crisis. J. Visc. Surg. 2020;157:S33–S42. doi: 10.1016/j.jviscsurg.2020.04.014. - DOI - PMC - PubMed
    1. Kelly ME, Murphy E, Bolger JC, Cahill RA. Covid-19 and the treatment of acute appendicitis in ireland: A new era or short-term pivot? Colorectal. Dis. 2020 doi: 10.1111/codi.15141. - DOI - PMC - PubMed
    1. Cano-Valderrama O, Morales X, Ferrigni CJ, et al. Reduction in emergency surgery activity during COVID-19 pandemic in three spanish hospitals. Br. J. Surg. 2020 doi: 10.1002/bjs.11667. - DOI - PMC - PubMed
    1. Guadalajara H, Muñoz de Nova JL, Fernandez Gonzalez S, et al. Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO study): Surgery may be the best treatment option. Br. J. Surg. 2020 doi: 10.1002/bjs.11950. - DOI - PMC - PubMed

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