Collateral damage: the impact of the COVID-19 pandemic on acute abdominal emergency presentations

Abstract Introduction In March 2020 the World Health Organization declared a pandemic caused by a novel coronavirus. Public information created awareness as well as concern in the general population. There has been a reported decrease in the number of patients attending Emergency departments (ED) during the pandemic in previously published study. This is the first study to determine differences in the types of presenting illnesses, severity and rate of resultant surgical intervention during the pandemic. Methods and Materials We carried out a retrospective, observational cohort study comparing two groups of patients attending the ED at our tertiary-care academic hospital. A historical comparison cohort was obtained by reviewing the number of patients referred by the ED for abdominal CT between March 15th - April 15th, 2020 compared to March 15th - April 15th, 2019. CT reports were reviewed; primary pathologies, complications and subsequent surgical intervention was documented and compared between the two groups. Results 733 patients were included in the 2019 cohort and 422 patients were included in the 2020 cohort. In 2019 32.7% had positive CT findings increasing to 50.5% in 2020. The number of complications increased from 7.9% to 19.7%. The rate requiring surgical intervention increased from 26.3% to 47.6% in 2020. Conclusion To date, there is little published data regarding the presentation and severity of illnesses during COVID-19. This information has important public-health implications, highlighting the need to educate patients to continue to present to hospital services during such crises, including if a purported second wave of COVID-19 arises.