The impact of the COVID-19 pandemic on surgical emergencies

Aims The COVID-19 pandemic has had an enormous impact on elective surgical activity worldwide;however, its effect on emergency surgical referrals and admissions is not well documented. Understanding the volume and nature of such presentations is key to future resource allocation and guideline creation. Methods Surgical handovers from a 9-week period from the commencement of the first government restriction of non-essential travel (March 8th-May 10th 2020) were studied. A corresponding time period of usual surgical activity (March 10th-12th May 2019) was studied for comparison. Results During the pandemic period, 447 referrals (mean age 54, 4.9% COVID-19 positive) were received representing a 16.5% decrease compared to 2019 (n=521). The most common referral in each period was abdominal pain (n=255 vs 259). The duration of symptoms prior to admission and overall number of traumas did not differ between the periods. Fewer referrals for traumatic brain injuries and polytraumas and more symptomatic hernias, cellulitis and blocked/dislodged lines/tubes were seen during the pandemic. Conclusion The volume of surgical referrals and admissions was significantly decreased during the first wave of the COVID-19 pandemic. Traumas and abdominal pain were unaffected. An increase in several referrals for which patients would typically visit their general practitioner or have an expedited hospital appointment was seen.