The impact of COVID-19 on postoperative outcomes of emergency general surgery operations

Aims: During the pandemic due to Coronavirus disease 2019 (COVID-19) many elective operations were postponed, while emergency surgical operations inevitably continued. Emergency general surgery procedures are known to have worse outcomes compared to elective ones. Besides, it is conceivable that COVID-19 itself may worsen surgical outcomes due to it may cause respiratory distress and multi-organ dysfunction. We aimed to present patients’ data who underwent surgery due to trauma and emergency general surgery diseases during the COVID-19 pandemic and the effect of COVID-19 on surgical outcomes in this study. Methods: Two hundred and thirty-five patients who underwent surgery due to trauma or emergency between March 2020 and January 2021 were enrolled. Two groups were created according to the COVID-19 status as positive (n=16) and negative (n=219). The demographics, clinical, laboratory, and perioperative data were analyzed and compared between these groups. Results: The median age of the patients was 51 (18-97) years, and 144 (61.2%) of them were male. The most common diagnosis was acute appendicitis (n= 121, 51.5%) followed by ileus. Subgroup comparisons showed that the COVID-19 (+) group had more patients with comorbidity and had higher C-reactive protein values, these differences were significant (p= 0.049, p= 0.001, respectively). Open surgery was performed significantly more in the COVID-19 (+) group (p= 0.037). Serious postoperative complications and mortality were seen more in the COVID-19 (+) group, but the differences were not significant. Patients with COVID-19 had significantly longer hospital stay (p= 0.007). Conclusion: COVID-19 positivity was found to have a negative impact on postoperative surgical outcomes in terms of emergency operations. It is not clear whether this negativity is due to the COVID-19 disease itself or the worse characteristics of patients with COVID-19.