Challenges to delivering pediatric surgery services in the midst of COVID 19 crisis: experience from a tertiary care hospital of Pakistan

Background: Coronavirus disease 2019 (COVID-19) has greatly impacted pediatric healthcare facilities throughout the United States due to widespread case rescheduling and the implementation of supplementary COVID-19 perioperative protocols. To our knowledge, no studies have investigated the impact of COVID-19 on case volume, surgical timing, or operational aspects of cleft surgical procedures. The aim of this study is to investigate the impact that COVID-19 has had on cleft surgical care at our institution. Methods: A retrospective study comparing cleft surgical care in 2019 (the pre-pandemic cohort) and 2020 (the COVID-19 cohort) was designed. All patients who underwent a cleft surgical procedure from April 1st to August 31st in 2019 and 2020 were included for analysis. Procedures were stratified into 4 groups: primary cleft lip repairs, primary cleft palate repairs, alveolar bone grafting procedures, and revisional/secondary repair procedures. Variables investigated in this study included: surgical volume, number of patients receiving timely surgery, causes for untimely surgery, number of combined cases, number of delayed cases, delay time, time under anesthesia, and procedure length. Results: A total of 191 cleft surgeries, 102 in 2019 and 89 in 2020, were identified during the study period. We observed no statistically significant differences in cleft surgical volume and other investigated variables across all surgical subgroups from 2019 to 2020. Conclusion: Cleft surgical care was largely unaffected by COVID-19 despite high rates of case rescheduling and the addition of supplementary perioperative safety protocols. More studies are needed to assess the impact of COVID-19 on cleft surgical care at other cleft centers and to investigate the long-term outcomes of these patients.

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“…17,18 Travel restrictions in conjunction with the rescheduling of cases from the shut down in April may be responsible for this finding. 19…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on Cleft Surgical Care

Ferry

Beh

Dibbs

et al. 2021

FACE

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“…A total of 17.71% (5118/28,904) of all included publications were mainly about clinical care practices for non-COVID-19 patients during the COVID-19 pandemic (eg, [29][30][31][32][33]). The following authors published the highest number of publications related to this topic: Karthik Rajasekaran (n=14), Francesco Esperto (n=12), Raju Vaishya (n=9), Namrata Sharma (n=8), and Santosh G Honavar (n=8).…”

Section: Topic 2: Clinical Care Practices During the Covid-19 Pandemicmentioning

confidence: 99%

A Comprehensive Overview of the COVID-19 Literature: Machine Learning–Based Bibliometric Analysis (Preprint)

Abd‐Alrazaq¹,

Schneider²,

Mifsud³

et al. 2020

Preprint

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BACKGROUND Shortly after the emergence of the novel coronavirus disease (COVID-19), researchers rapidly mobilized to study numerous aspects of the disease such as its evolution, clinical manifestations, effects, treatments, and vaccination. This led to a rapid increase in the number of COVID-19-related publications. Identifying trends and areas of interest using traditional review methods (e.g, scoping review and systematic reviews) for such a large domain area is challenging. OBJECTIVE We aimed to conduct an extensive bibliometric analysis to provide a comprehensive overview of the COVID-19 literature. METHODS We used the COVID-19 Open Research Dataset (CORD-19) that consists of enormous number of articles related to all coronaviruses. We used machine learning method to analyse most relevant COVID-19 related articles and extracted most prominent topics. Specifically, we used clustering algorithm to group articles based on similarity of their abstracts to identify the research hotspots and current research directions. RESULTS Of the 196,630 publications retrieved from the database, we included 28,904 in the analysis. The mean number of weekly publications was 990 (SD=789.3). The country that published the highest number of articles was China (n=2,950). The largest number of documents was published in BioRxiv. Lei Liu affiliated in the Southern University of Science and Technology in China published the highest number of documents (n=46). Based on titles and abstracts alone, we were able to identify 1,515 surveys, 733 systematic reviews, 512 cohort studies, 480 meta-analyses, 362 randomized control trials. We identified 19 different topics addressed by the included studies. The most dominant topic was public health response followed by clinical care practices during COVID-19, its clinical characteristics and risk factors, and epidemic models for its spread. CONCLUSIONS We provided an overview of the COVID-19 literature and identified current hotspots and research directions. Our findings can be helpful to the research community by helping prioritize research needs, and recognize leading COVID-19 researchers, institutes, countries, and publishers. This study showed that an AI-based bibliometric analysis has the potential to rapidly explore large corpora of academic publications during a public health crisis. Publishers should avoid noise in the data by developing a way to trace the evolution of individual publications and unique authors.

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“…At our institute, a not-for-profit tertiary care hospital in the city of Karachi, Pakistan, similar measures were taken [ 4 ], as elective and semi-elective procedures were cancelled. For the three-month period from April to June 2020, our pediatric surgery department, consisting of six pediatric surgeons, operated on approximately 152 elective and emergency cases, which is one-third the volume compared to the preceding three months.…”

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confidence: 99%

“…An effective way to address these issues is to ensure that patients are informed. This could be accomplished through various channels, including mass and social media and specific messages to patients on the deferral list describing the measures implemented for the availability of surgical capacity, pre-operative testing, and the division of the hospital and the operating room into two zones, with one zone solely dedicated to suspected and confirmed COVID cases [ 4 ].…”

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confidence: 99%