Lockdown effect on emergency surgical consults during the covid-19 outbreak: Experience of a pandemic hospital

The covid-19 pandemic has significantly impacted many lives and health care systems around the world. Many countries have imposed lockdowns and extraordinary restriction measures including curfews to control the disease. This study aimed to evaluate the lockdown effect on surgical emergencies during this outbreak. Patients admitted to the emergency department (ED) and referred to general surgery (GS) was retrospectively analyzed during the first lockdown period (April 1-May 31,2020) and before the covid-19 pandemic, corresponding time last year (April 1-May 31,2019). Patient admission rates to ED and general surgery outpatient clinics, patient characteristics, reasons for consultation, hospitalization rates, surgical intervention requirements, and reasons for urgent surgery were compared. A significant reduction was observed in the number of patients admitted to ED, and general surgery consultation is required in the covid-19 lockdown period (72% and 32% decrease respectively). There was no difference in hospitalization and surgical intervention rates between the groups (p=0.158 and p=0.871 respectively). The number of patients referred to general surgery with a diagnosis of perianal disorders was significantly higher in the lockdown group. Covid-19 lockdown and restrictions have dramatically decreased general surgery patients' admissions to emergencies. This situation suggests that some patients with serious diseases may not apply to the emergency departments and so may delay their treatments. Establishing pandemic hospitals and directing uninfected patients to centers other than pandemic hospitals can reduce these delays. We hope, this study findings will be guiding health authorities in making rearrangements in hospitals during subsequent waves and lockdowns in this pandemic and other new pandemic in the future.