Impact of the COVID-19 pandemic on colorectal surgical outcomes at an epicenter frontline institution

Purpose/Background: Data related to surgical outcomes during the COVID-19 pandemic are limited We evaluated the impact of the pandemic on the surgical practice and patient outcomes at a busy colorectal unit, in a New York (NY) COVID-19 front-line hospital Methods/Interventions: Colorectal surgery patients during the NY 6-week case indices upslope and plateau phase ('Pandemic' group, PG) were compared to those who underwent surgery the previous 6 weeks ('Prepandemic' group, PPG) for patient and recovery outcomes, COVID-19 status and care delays Results/Outcome(s): Of 58(39 abdominal;19 anorectal) PG patients (164 needed surgery) and 166 PPG patients(73 abdominal, 93 anorectal) operated, abdominal surgery was more common in PG(34 8% vs 17%, p=0 033) For abdominal surgery, age, gender, and surgical indication were similar, while PG had lower BMI More PG patients had ostomy creation, ileocolic resection, right colectomy, low anterior resection, and APR(p=0 006) Time from consultation to surgery(18 vs 8 days, p=0 02) was longer in PG SSI(2 6% vs 8 3%, p=0 24), LOS(3 vs 4 days, p=0 28), anastomotic leak(2 6% vs 0%, p=0 2), pneumonia(2 6% vs 5 5%, p=0 5), and reintubation(2 6% vs 0 0%, p=0 2) were similar Time from check-in to surgery, operative time and to recovery room were similar Two of 18 asymptomatic patients tested preoperatively were COVID-19 positive Three of 4 patients tested postoperatively were positive There were no adverse COVID-19 outcomes Conclusions/Discussion: Judicious planning allows ongoing prompt and safe surgery during the pandemic's peak, even at an epicenter frontline hospital