Transforming a surgical department during the outbreak of new coronavirus pandemic. Clinical implications

• Published in: Langenbeck's archives of surgery Vol. 405; no. 6; pp. 867 - 875
• Main Authors: Vilallonga, Ramon, Garcia Ruiz de Gordejuela, Amador, Cossio-Gil, Yolima, Domínguez González, José Manuel, Martín Sánchez, Rocio, Armengol Carrasco, Manel
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2020
• Subjects: Abdominal Surgery; Betacoronavirus; Cardiac Surgery; Coronavirus Infections - epidemiology; COVID-19; Critical Care - organization & administration; General Surgery; Hospital Bed Capacity; Humans; Medicine; Medicine & Public Health; Original; Original Article; Pandemics; Pneumonia, Viral - epidemiology; Retrospective Studies; SARS-CoV-2; Surgery Department, Hospital - organization & administration; Tertiary Care Centers - organization & administration; Thoracic Surgery; Traumatic Surgery; Vascular Surgery; COVID-19; Pneumonia; Hospital remodeling; Severe acute respiratory syndrome-coronavirus-2
• ISSN: 1435-2443; 1435-2451
• DOI: 10.1007/s00423-020-01931-x

Background The 2019 novel coronavirus (2019-nCoV) has caused an outbreak of the disease now officially named coronavirus disease 2019 (COVID-19). Since then, all hospitals have required a complete restructuring of their usual facilities and the treatments provided. Our goal was to detail the remodeling of a tertiary hospital during the COVID-19 outbreak and analyze pitfalls to avoid increasing surgical department burdens. Methods This was a retrospective analysis of data affecting patients during their admission in our institution during March 2020. Data from general admission, intensive care units, and elective and emergency surgeries were collected and analyzed. All patients who underwent a surgical procedure were reviewed to elucidate limitations in the deployment of the hospital transformation to a COVID-19 hospital. Results A total of 688 patients have been treated in our institution. Of those, 186 required intensive care. More than 120 new intensive care beds have been created during this period, and a decrease in elective surgeries of more than 75% was observed. Inadvertent COVID-19 patients accounted for 70%. Thirty percent of the patients who underwent surgery while infected with COVID-19 died in our institution. Conclusions The complete reorganization of surgical departments will be requested during the outbreak and adaptive solutions are needed in order to avoid increased mortality rates and infection among patients and to promote maximal optimization of surgical spaces. Timing, governmental decisions, and scientific society’s recommendations may be limitations in the efficient deployment of hospital transformations to COVID-19 facilities.