OBJECTIVE: To assess how the COVID-19 outbreak has affected emergency general surgery (EGS) care during the pandemic, indications for surgery, types of procedures, perioperative course, and final outcomes .
METHODS: This is a retrospective study of EGS patients during the pandemic period . The main outcome was 30-day morbidity and mortality according to severity and COVID-19 infection status . Secondary outcomes were changes in overall management . A logistic regression analysis was done to assess factors predictive of mortality .
RESULTS: One hundred and fifty-three patients were included . Half of the patients with an abdominal ultrasound and/or CT scan had signs of severity at diagnosis, four times higher than the previous year . Non-COVID patients underwent surgery more often than the COVID group . Over 1/3 of 100 operated patients had postoperative morbidity, versus only 15% the previous year . The most common complications were septic shock, pneumonia, and ARDS . ICU care was required in 17% of patients, and was most often required in the SARS-CoV-2-infected group, which also had a higher morbidity and mortality . The 30-day mortality in the surgical series was of 7%, with no differences with the previous year . The strongest independent predictors of overall mortality were age> 70 years, ASA III-IV, ESS> 9, and SARS-CoV-2 infection .
CONCLUSIONS: Non-operative management (NOM) was undertaken in a third of patients, and only 14% of operated patients had a perioperative confirmation of -CoV-2 infection . The severity and morbidity of COVID-19-infected patients was much higher . Late presentations for medical care may have added to the high morbidity of the series.