COVID-19: From resource restriction to surgical services – How we waived off the waves

Abstract

Objectives: In India, more than 43 million people were infected with the novel coronavirus (CoV), and more than 0.5 million deaths occurred in 2020– 2022. This severely affected the surgical services as well as the management of non-CoV disease (COVID) patients, especially in a transformed tertiary COVID care center. Materials and Methods: This cohort study was conducted at the Department of Surgical Gastroenterology, Medical College Hospital, Kolkata, India, from March 12, 2020, to May 31, 2022. The study included patients hospitalized for gastrointestinal surgeries matched with those having the same pathology and treated before February 29, 2020, (pre-pandemic) in a 1:1 ratio. Patients treated primarily in other departments and those who died undiagnosed were excluded from the study. Results: In total, 344 patients were operated on. A comparison of 30-day mortality did not show any significant difference (P = 0.74, odds ratio [OR]: 0.093, 95% confidence interval [CI]: 0.021–2.458). Time to admission (P = 0.003, OR: 1.512, 95% CI: 0.124–3.587) and time to surgery (P < 0.001, OR: 2.031, 95% CI: 0.023–6.738) were significantly high. Only pulmonary complications (P = 0.002, OR: 1.958, 95% CI: 1.021–3.968) were significantly high in the COVID-19 era. Patients infected with CoV in the perioperative period had a significantly higher morbidity (n = 50, OR: 2.58, 95% CI: 1.74–14.62). Conclusion: When scientifically managed, improved outcomes may be expected in the pandemic, even though many stones of epidemiology remain unturned.