COVID-19 and surgery. Impact on volumes of care, postoperative complications and mortality. Results after one year of the pandemic

• Published in: Revista argentina de cirugía Vol. 114; no. 4; pp. 307 - 316
• Main Authors: Latif, Jorge A., Lorenzo, Mauro J., Solla, Ricardo, Segovia, Gonzalo, Mitidieri, Alejandro, Coturel, Adelina, Rojas Huayta, Jorge, Kohan, Gustavo
• Format: Journal Article
• Language: English
• Published: 01.12.2022
• ISSN: 0048-7600; 2250-639X
• DOI: 10.25132/raac.v114.n4.1671

Background: The COVID-19 pandemic produced significant changes in the care and treatment of surgical patients. Objectives: The aims of this study were to compare the volume of services provided during a year of pandemic with an equal period without pandemic, estimate its impact on health care and institutional care, and compare COVID-positive versus COVID-negative patients to determine postoperative complications, mortality and risk factors associated with these events. Material and methods: We conducted an observational and retrospective study, comparing the volume of services performed between March 19, 2020, and March 18, 2021, with the same period in 2019/2020. We performed a matched cohort study (in a 2:1 ratio) between patients with and without COVID-19 and analyzed the postoperative complications, mortality, and twelve objective variables as associated risk factors. Results: There was a significant decrease in planned hospitalizations and non-urgent surgeries and endoscopies, while all the other variables showed a non-significant reduction. Of the 979 admissions, 41 corresponded to COVID-positive patients (4.1%). Mortality was 29.2% in COVID-positive patients (12/41) vs. 7.3%% in those COVID negative (p = 0.021). The significant risk factors associated with mortality were age ≥75 years, male sex, COVID+, emergencies, pneumonia, requirement of ICU and MV. Patients operated on had a significantly higher rate of pneumonia. Logistic regression analysis between COVID+ patients and COVID- patients showed that COVID+ and need for MV were predictors of mortality. In COVID+ patients, only MV was a determinant of mortality. Conclusion: The COVID-19 pandemic reduced healthcare services and increased mortality in patients infected with the virus.