Outcome of general surgical emergent and urgent elective procedures in coronavirus disease 2019-infected patients in Ain Shams University, El-Obour Hospital

Background The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 has been associated with 273 million registered coronavirus disease 2019 (COVID-19) cases. COVID-19 infection has been proved in 340 000 Egyptians as registered by the Ministry of Health. Surgery in COVID-19-infected patients has special risks and considerations. This study discusses the outcome of emergency and urgent surgery in COVID-19-infected patients. Aim To assess morbidity and mortality rates among COVID-19-positive acute surgical patients in Ain Shams El-Obour Hospital and to compare our results with the literature and evaluate the effect of COVID-19 as a risk factor in comparison with other well-known risk factors. Patients and methods Emergency and urgent operative interventions were performed for 103 patients with the preoperative diagnosis of COVID-19 infection. They were transferred to Ain Shams El-Obour Hospital, which was assigned to management of COVID-19-infected patients. All patients were assessed regarding comorbidities, surgical condition, surgical intervention, postoperative complications, and postoperative mortality. Results Postoperative mortality was 27.2%. Postoperative pulmonary complications were most common (14%). Sepsis either related to pneumonia or other source of sepsis occurred in 12% of cases and thromboembolic events were recorded in 6.8% of cases. Conclusion COVID-19 infection is associated with increased postoperative mortality. Mortality was related to increased age, severity of the surgical condition, CO-RADS score, and anesthesia type. It is advised to postpone unnecessary surgical intervention in patients with COVID-19 infection owing to high incidence of perioperative complications. However, it was noticed that unnecessary delay may worsen the outcome. Continuous evaluation of the surgical condition as well as the pulmonary and general condition is key to achieving the best outcome in COVID-19-infected patients.