Impact of COVID-19 outbreak on emergency surgery and emergency department admissions: an Italian level 2 emergency department experience

Castagneto-Gissey, Lidia; Casella, Giovanni; Russo, Maria Francesca; Corpo, Giulia Del; Iodice, Alessandra; Lattina, I; Ferrari, Paolo; Iannone, Immacolata; Mingoli, Andrea; Torre, Filippo La

doi:10.1002/bjs.11813

Cited by 28 publications

(35 citation statements)

References 3 publications

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“…As COVID-19 cases increased and further restrictions were implemented, health-seeking behaviour changed dramatically in England, with health service attendances decreasing from week 12 across all syndromic indictors [1,[18][19][20][21][22]. Similar decreases were observed internationally, with speculation that reduced healthcare usage was due to public avoidance, with some evidence that those with milder symptoms were least likely to seek care [3][4][5][6][7]23]. However, behavioural surveys conducted during late lockdown and lockdown easing found 70-80% of participants had continued to seek care, if needed [24][25].…”

Section: Discussionmentioning

confidence: 80%

“…There is a growing body of evidence indicating that the COVID-19 pandemic and implemented control measures have had indirect impacts on other health conditions. Substantial decreases have been observed in emergency department (ED) attendances, with decreasing presentation of conditions such as strokes, surgical emergencies and cardiac emergencies, delays to cancer diagnoses, and concerns raised about delayed presentation and associated negative outcomes [3][4][5][6][7]. Less well documented are any indirect effects on communicable diseases, which are often controlled using similar nonpharmaceutical interventions to those implemented in the COVID-19 response [8].…”

Section: Introductionmentioning

confidence: 99%

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The impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February – July 2020

Elliot

et al. 2021

Preprint

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Objective: To establish the impact of the first six months of the COVID-19 outbreak response of gastrointestinal (GI) infection trends in England. Design: Retrospective ecological study using routinely collected national and regional surveillance data from eight Public Health England coordinated laboratory, outbreak and syndromic surveillance systems using key dates of UK governmental policy change to assign phases for comparison between 2020 and historic data. Results: Decreases in GI illness activity were observed across all surveillance indicators as COVID-19 cases began to peak. Compared to the 5-year average (2015-2019), during the first six months of the COVD-19 response, there was a 52% decrease in GI outbreaks reported (1,544 vs. 3,208 (95% CI: 2,938 - 3,478) and a 34% decrease in laboratory confirmed cases (27,859 vs. 42,495 (95% CI: 40,068 - 44,922). GI indicators began to rise during the first lockdown and lockdown easing, although all remained substantially lower than historic figures. Reductions in laboratory confirmed cases were observed across all age groups and both sexes, with geographical heterogeneity observed in diagnosis trends. Health seeking behaviour changed substantially, with attendances decreasing prior to lockdown across all indicators. Conclusions: There has been a marked change in trends of GI infections in the context of the COVID-19 pandemic. The drivers of this change are likely to be multifactorial; while changes in health seeking behaviour, pressure on diagnostic services and surveillance system ascertainment have undoubtably played a role there has likely been a true decrease in the incidence for some pathogens resulting from the control measures and restrictions implemented. This suggests that if some of these changes in behaviour such as improved hand hygiene were maintained, then we could potentially see sustained reductions in the burden of GI illness.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

The impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February – July 2020

Elliot

et al. 2021

Preprint

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“…Studies reported an extreme decline in surgical number because of COVID-19 with a total variation rate of −88⋅2 [4]. Another study reported the −42.8% variation on admitting surgical cases and −25.4% variation rate on emergency surgical procedures [5].…”

Section: Introductionmentioning

confidence: 99%

COVID-19 pandemic and its impact on emergency surgical services: A mini-review

Riaz¹,

Obeysekera²,

Itani³

2021

Int. J. Biol. Pharm. Sci. Arch.

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Background: The global COVID-19 spread is unquestionably one of the leading obstacles of every healthcare system, patient, and healthcare professionals. This leading pandemic has immeasurable effects on every healthcare domain, including surgical care, especially surgical demand for emergency settings. Methods: An extensive data search was done from two leading databases Medline (PubMed) and Google Scholar, by using different keywords. The literature search was done both using individual and combination of keywords. All relevant data published from December 2019 to April 2021 were included and narratively analyzed. Results: Thirteen articles were selected based on COVID-19 and its consequences on emergency Surgical Services including recommendations, guidelines, prioritization, and reporting of surgical case reduction. Conclusion: This global COVID-19 pandemic had influenced all domains of surgery, including emergency surgery, which required urgent surgical attention. Training and multidisciplinary support are necessary for the surgical teams to perform in this critical situation.

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“…9 As time has progressed, a growing number of publications have begun reporting on the indirect impact of COVID‐19 on emergency and elective surgery worldwide. Despite differences in settings, country, surgical procedure and time‐points analysed, the overall volume of emergency surgeries have decreased anywhere between 8% and 81%, 10 , 11 , 12 , 13 whereas elective surgery has decreased between 33% and 62%. 1 , 11 , 12 Although the road ahead still remains unclear, it is evident that contemporaneously demonstrating both the ongoing repercussions of the COVID‐19 pandemic and the organisational response on the delivery of hospital surgical services is important for contributing to the knowledge base and future decision making.…”

Section: Introductionmentioning

confidence: 99%

From the sidelines: The indirect repercussions of COVID‐19 on the delivery of hospital surgical services

McBride

Steffens

Solomon

2021

ANZ Journal of Surgery

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Background Despite relatively few COVID‐19 cases within New South Wales, the uncertainty surrounding the pandemic has prevented a return to business as usual for the delivery of surgical services. This study aims to describe the evolving impact of COVID‐19 on surgical activity and patient outcomes at a major public tertiary referral hospital. Methods A retrospective cohort study involving adult surgical patients treated at a large public tertiary referral hospital in Sydney, Australia. Surgical activity, surgical outcomes and patient demographics were compared across two time periods, including the ‘first wave’ (February–May 2020 vs. February–May 2019) and the ‘perseverance phase’ (June–September 2020 vs. June–September 2019). Variables across both groups were compared using an independent t test or chi‐squared test. Results A −32% reduction in surgical separations was observed in the ‘first wave’, including −20% emergency and −37% elective. In the ‘perseverance phase’, there was a −19% reduction in surgical activity, including 0% emergency and −27% elective. The average length of stay, intensive care admissions, postoperative complications and in‐hospital costs significantly increased in the ‘first wave’. The proportion of public patients increased marginally (3%) in the ‘first wave’. Conclusion The impact of COVID‐19 was most severely experienced in the initial months of the pandemic and observed in the number of patients treated. Although there was an initial effect on surgical outcomes, overall, the standard of care remained safe. The delivery of elective surgery remains a challenge and reflects the ongoing system‐wide changes that are required to manage the COVID‐19 pandemic.

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Impact of COVID-19 outbreak on emergency surgery and emergency department admissions: an Italian level 2 emergency department experience

Cited by 28 publications

References 3 publications

The impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February – July 2020

The impact of the COVID-19 pandemic on gastrointestinal infection trends in England, February – July 2020

COVID-19 pandemic and its impact on emergency surgical services: A mini-review

From the sidelines: The indirect repercussions of COVID‐19 on the delivery of hospital surgical services

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