Emergency General Surgery and COVID-19 Pandemic: Are There Any Changes? A Scoping Review

Abstract

Background and Objectives: The pandemic of SARS-CoV-19 has affected the overall spectrum of General Surgery, either in the case management part, or in the type of cases. The purpose of this review is to gather all the parameters affected and to compare these changes between the pandemic period and the corresponding time frame of the previous year. Materials and Methods: A review of literature in two electronic databases (PubMed and Scopus) was performed examining studies during the pre-pandemic (March to May 2019) and pandemic (March to May 2020) period about emergency surgeries. The differences in case presentation in emergency rooms, patient characteristics, length of hospitalization, type of surgery, complications and mortality rate were compared. Results: The comparison of the studies revealed significant results highlighting the differences between the two time periods for each parameter. There has been observed an overall decrease in the number of cases presented for emergency and urgent surgery. In terms of age, sex, and BMI, there were no significant variations amongst the patients. About the length of hospitalization, the patients hospitalized longer during the pandemic period. In terms of pathologies, the most common types of surgery were appendectomy, gastrointestinal, and colorectal resection. Mortality did not differ between the two study periods. Conclusions: COVID-19 affected a large part of Emergency General Surgery mainly concerns the type of operations performed. The hospitalization of patients, the complications that may have arisen and the recognition of emergencies were the most important issues faced by health care officials in hospitals during the period of COVID-19; however, there were parameters like mortality and patients’ characteristics that did not appear to differ with pre-pandemic era.

Impact of the COVID-19 Pandemic on Elective and Emergency Surgeries, and Postoperative Mortality in a Brazilian Metropolitan Area: A Time-Series Cohort Study

“…In a scoping review, it was observed that there was a delay in patients seeking care in emergency general surgeries, but it was impossible to conclude that there were more complications or increased mortality during the pandemic. 57 Our study has some limitations. Firstly, there is a lack of information on the specific indications for elective and emergency surgeries, preoperative evaluations, surgery waiting time, and the complete demographic characteristics of the patients, including their socioeconomic status and schooling level.…”

“…In a scoping review, it was observed that there was a delay in patients seeking care in emergency general surgeries, but it was impossible to conclude that there were more complications or increased mortality during the pandemic. 57 …”

Impact of the COVID-19 Pandemic on Gyne-Oncological Treatment—A Retrospective Single-Center Analysis of a German University Hospital with 30,525 Patients

“…On the other side, an adverse development of cardiac emergency care has been reported with inexplicable low numbers, i.e., of myocardial infarction, during phases of high COVID-19 incidence [ 25 ]. Further articles show that this development does not only apply to medicine but also to emergency and elective surgery of all kinds [ 4 , 5 , 26 , 27 ]. Di Martino et al provide an interesting study that connects the fields of oncology with surgery by assessing the variations in elective oncological surgery on colorectal and breast cancer during the first pandemic year of 2020 in comparison to the previous years of 2018 and 2019.…”

“…Two and a half years of the pandemic have left their mark on German healthcare provision with a total of 28,180,861 cases, 195,698 intensive care unit (ICU) treatments, and 141,105 confirmed deaths [ 2 ]. The strained resilience of many health systems has resulted in shortcomings in a variety of care sectors covering the whole spectrum of acute to elective medicine and led to deleterious effects on the treatment of many disorders [ 3 , 4 , 5 ]. Healthcare systems, including the German one, have navigated through the unknown pandemic dynamics by applying predictive modeling and policymaking that included distinct restrictions on medical care [ 6 , 7 ].…”

Editorial for the Special Issue “Emergency Medicine and Emergency Room Medical Issues”

“…The management of emergency rooms during the outbreak changed all around the world, as protective equipment, isolation rooms and contumacial areas were measures adopted in the first wave of the pandemic [ 1 , 2 ], with continuous and sequential changes in triage systems [ 3 ]. In fact, surgical procedures routinely decreased during the first waves of the pandemic, because all intensive areas were used to manage severe COVID-19 cases [ 4 ]. Additionally, these simple changes induced, together with all other aspects of the pandemic and its life-threatening potential, psychological stress among emergency room workers [ 5 ].…”