key: cord-0951666-uxv7mt3u
authors: Guadalajara, H; Muñoz de Nova, JL; Fernandez Gonzalez, S; Yiasemidou, M; Recarte Rico, M; Juez, LD; García Septiem, J; Galindo Jara, P; García Virosta, M; Lobo Martínez, E; Martín‐Pérez, E; García‐Olmo, D
title: Patterns of acute surgical inflammatory processes presentation of in the COVID‐19 outbreak (PIACO Study): Surgery may be the best treatment option
date: 2020-08-21
journal: Br J Surg
DOI: 10.1002/bjs.11950
sha: f3cacad9438bcac1c219b1e4675c99a867bf3e7c
doc_id: 951666
cord_uid: uxv7mt3u

nan

Since the first case of SARS-CoV-2 was confirmed, lives were altered in many ways, elective surgery was discontinued and outpatient clinics were cancelled or altered to phone consultations 1-5 . Anecdotal evidence suggests a reduction of acute surgical admissions, however there is paucity of studies looking into the causative factors. It was anticipated by some that as a result of the 'lock-down' patients would deteriorate at home without access to hospital treatment, leading to late presentations.

We performed a multicentre study at sixteen hospitals aiming to evaluate the patients with acute surgical inflammatory processes (ASIP) (appendicitis, cholecystitis, diverticulitis and perianal abscesses) during the COVID-19 outbreak and compare it with the same timeframe in 2019. Consecutive patients from March 14th 2020 (date of the declaration of the state of alarm by Spanish Government) until the May 2th 2020 (beginning of the gradual de-escalation plan) were included. In total, 521 patients were treated for ASIP in 2020 (cases) and 822 in 2019 (controls). This represents a 36⋅6% (appendicitis -33⋅4%, cholecystitis -22⋅9%, diverticulitis -60% anal perianal abscesses -41%) reduction. The higher reduction was observed in mild and moderate cases (-49⋅3% and -19⋅5%, respectively), with a similar number of severe cases (86 vs. 97; variation -11⋅3% Our conclusion is that, whilst the COVID-19 outbreak led to delayed presentations and selected more severe ASIP cases, the positive COVID-19 status itself did not have a direct impact on either mor-bidity or mortality. Based on these results, we recommend that treatment of ASIP cases to retrovert to that of pre-COVID era (i.e. surgery > conservative management).

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