Impact of COVID-19 on surgical emergency presentations in a tertiary hospital in the developing world

Abstract

BACKGROUND: The COVID-19 pandemic and the institution of measures to contain the spread of the virus have disrupted patients' elective and emergency care, with scarce resources being channeled towards care of emergency presentations and containing the virus. The study aimed to assess the impact of COVID-19 on surgical accidents and emergency presentations in a major teaching hospital.

METHOD: This was a comparative retrospective study. All presentations between February to July 2019 (non-COVID-19 period) were compared with the same period in 2020 (COVID-19 period). Patients' biodata, including surgical specialty that managed the patient, diagnosis, and treatment offered, were collated and analyzed with IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: I.B.M. Corp.

RESULTS: We included 3463 patients in the study; 2419 (69.9%) were males, while 1044(30.1%) were females. The mean age of the patients in 2019 was 31.83 ±19.31 years, and that of 2020 was 34.93±19.99 years (P=0.001). During the lockdown period, emergency surgical presentations declined significantly by 17% (1894 versus 1569: P=0.001). There was a general decline in surgical emergency presentations across surgical specialties, with orthopedic and otorhinolaryngology (E.N.T.) having the greatest impact (313 versus 202 P=0.044). Presentation for trauma decreased by 18% (1394 versus 1144 P=0.711). Operative interventions declined by 47% (292 versus 155 P=0.001). There was a decline of 31% in the number of admissions for in-patient care (420 versus 290 P=0.019).

CONCLUSION: The COVID-19 lockdown in Nigeria was associated with a reduction in the number of surgical emergency presentations and surgical interventions.