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Background The coronavirus disease 19 (COVID-19) has had a profound impact on our healthcare system. Surgery in particular faced significant challenges related to allocation of resources and equitable patient selection, resulting in a delay in non-emergent procedures. We sought to study the impact of the COVID-19 pandemic on patient outcomes after thyroidectomy. Methods This was a cross-sectional study using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database that included all thyroidectomies from 2018 to 2020. The primary outcome evaluated was surgical outcomes during 2020, the first year of the pandemic, compared to years preceding the pandemic. Factors associated with adverse postoperative outcomes during the study period were included in a multivariate analysis. Results The volume of thyroidectomy procedures in 2020 decreased 16.4% when compared to the preceding years. During 2020, there was a significant increase in mortality (0.14% vs. 0.07%, p = 0.03), unplanned intubation (0.45% vs. 0.27%, p < 0.01) and cardiac arrest (0.11% vs. 0.03%, p < 0.01), while other complications remained stable. Undergoing surgery in 2020 remained as a risk factor for mortality in a multivariate analysis (OR 2.4 95% CI 1.3–4.4). Conclusion The first year of the COVID-19 pandemic had a significant impact on outcomes after thyroidectomy resulting in increased mortality. As the world recovers, there will likely be an increase number of patients seeking care who were unable to obtain it during the pandemic. Close attention should be placed on the outcomes which were altered during the pandemic.

Objective: Intraductal papillary mucinous neoplasm (IPMN) and pancreatic neuroendocrine tumors (PNET) are distinct pathological entities. Their association, however, has been reported in small series. We seek to validate this association in a larger series. Methods: A retrospective review of a prospectively collected database (2000e2015) of patients undergoing pancreatectomy at a single academic center was performed. The prevalence of IPMN and PNET was compared to historical autopsy data. Patients with IPMN alone (n = 526) and PNET alone (n = 376) were compared to patients with IPMN and PNET (IPMN-PNET). Results: Of 526 patients with resected IPMN, 15 (2.8%) had PNET on pathology. Of these, PNET was incidentally discovered on pathology in 12 (80%). Correspondingly, PNET size was smaller (9 vs. 34 mm, p < 0.0001) compared to PNET alone patients, and never associated with positive lymph nodes. Despite this, there was no difference in overall tumor stage, and all PNET in IPMN-PNET patients were nonfunctional. The prevalence of PNET in IPMN patients was similar to PNET prevalence in historical autopsy data (2.8% vs 0.8e10%). IPMN-PNET were older than PNET alone (66.8 vs. 56.4 years, p = 0.009) patients, whereas IPMN-PNET had demographic characteristics comparable to IPMN alone. There was no difference in IPMN subtype or degree of dysplasia between IPMN-PNET and IPMN alone patients. Conclusion: The association of IPMN and PNET has been described in the literature. Our large series indicates that PNET are not more frequent in IPMN patients and most are incidentalomas on pathology with likely no clinically relevant impact. Additional screening for PNET (e.g., serum Chromogranin A) is not indicated in IPMN patients.

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