Has Something Changed in the COVID-19 Outbreak in Emergency Surgery? Experience with a Single Core

Background: The current coronavirus disease 19 (COVID-19) pandemic is reshaping health-care delivery and has had a significant effect on surgical patient management. Surgical operations were gradually decreased at the General Surgery Department of Sant' Anna University Hospital in Ferrara, Italy, during the peak of the COVID-19 outbreak in Italy. Just one operating room was available for elective cancer surgery and another for emergency procedures during this period.Furthermore, the number of surgical patient beds had to be reduced in order to make room for the new COVID-19 wards. Aim: To compare two time spans (March 9 to April 9 2019 and March 9 to April 9 2020), looking for variations in the number and form of emergency surgery operations at a main university hospital in Ferrara, Emilia Romagna, northern Italy. The analysis of patient results was a secondary goal. Methods: This retrospective study was carried out at the General Surgery Department of Sant’ Anna University Hospital in Ferrara, Italy. During the peak of the COVID-19 outbreak in Italy and the ensuing complete lockdown, we looked at the number of emergency surgeries conducted and patient outcomes. The number of surgeries performed and their results over the same time in 2019 were then compared. The study examined all adult patients who underwent emergency surgery from March 9 to April 9, 2019 (n = 46) and those who underwent surgery during the first month of the lockdown, from March 9 to April 9, 2020 (n = 27).  Age, gender, American Society of Anesthesiologists classification ratings, and styles of surgery were all factored into the analyses. To summarise the results, descriptive statistics were obtained. Results: During the first month of the lockdown (March 9 – April 9, 2020), a total of 27 patients underwent emergency surgery at Sant' Anna University Hospital in Ferrara. In comparison to the same timeframe in 2019, this reflects a 41.3 percent decrease in the number of patients who were admitted and underwent emergency surgery. The complication rate during the pandemic period was substantially higher than it was during the analogous period in 2019: 15 out of 27 cases from March 9 to April 9, 2020 (55) vs 17 out of 46 cases from March 9 to April 9, 2019 (36.9). Of the 27 patients who underwent emergency surgery during the pandemic, 10 were screened for COVID-19 using both thorax high resolution computerized tomography and a naso-pharyngeal swab, while 9 only underwent thorax high resolution computerized tomography. Only 1 patient tested positive for SARS-CoV-2 and died following surgery. Conclusion: During the COVID-19 pandemic, our centre had seen a significant reduction in emergency surgeries, and it's likely that other centres across Italy had similar reductions.