Surgery in the Time of COVID-19 Pandemic

Study Overview
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Brief Summary
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The ongoing coronavirus disease 2019 (COVID-19) which started in China, was declared on the 11th of March as a global pandemic 2020 by the World Health Organization (WHO). Governments around the world have introduced differing forms of lock downs since the start of the pandemic demanding citizens to confine to their homes and go out only in necessity to minimize exposure to the virus. The response was observed in the emergency departments and the number of patients who presented for non-Covid issues drastically reduced. Hospitals activated their mass casualty management plans and have reorganized and overstretched their capacity to be able to absorb both the influx of patients with the virus and those with other conditions. Part of that reorganization was reducing the surgical activity. The main focus was shifted to patients who are considered urgent and elective surgery were postponed. Hence only surgical emergencies were maintained. Many did not present to the emergency department for fear to contract the virus and from a sense of national and global solidarity against that pandemic. Whereas these measures are essential to prevent the spread of the virus, it may be hypothesized that for non-Covid issues, including surgical emergencies, patients may present late to the emergency department due to fear of contracting the infection in hospital. This would delay their management and lead to a worsened symptomology on presentation requiring a more complex surgical intervention with an increased complication profile. The investigators present initial data from four major hospitals in Belgium, characterizing surgical emergencies that were managed since the start of the pandemic and discuss the repercussion the pandemic has on management of urgent surgical patients and most likely evolution of surgery after the pandemic.

Official Title
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Surgery in the Time of COVID-19 Pandemic

Conditions
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Covid19

Intervention / Treatment
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* Other: Data extraction from medical files


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who had a surgical procedure since the start of the lock down in Belgium due to the COVID19 pandemic (16 of March 2020 to the 12 of April 2020). Exclusion Criteria: None
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Surgical intervention<br>Patients who had a surgical procedure since the start of the lockdown in Belgium due to the COVID19 pandemic (16 of March 2020 to the 12 of April 2020. | Other: Data extraction from medical files<br>* Data extraction from medical files<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Surgery code | Type of surgery as defined by the surgery code | 5 minutes | 
| Urgency | Degree of urgency of the surgery | 5 minutes | 
| Type of anesthesia | Type of anesthesia | 5 minutes | 
| Delay between surgery and first symptoms | Delay between surgery and first symptoms | 5 minutes | 
| Surgery duration | Surgery duration (anesthesia included) | 5 minutes | 
| Hospital stay (in days) | Hospital stay (in days) | 5 minutes | 
| Intensive care unit stay (in days) | Intensive care unit stay (in days) | 5 minutes | 
| Post-op complications | Post-op complications | 5 minutes | 
| Covid status before surgery | Covid status before surgery (positive=1, negative=0 ) | 5 minutes | 
| Covid status post-surgery | Covid status post-op (positive=1, negative=0 ) | 5 minutes | 
| COVID19 Diagnosis by CT scan | COVID19 Diagnosis confirmed by CT scan of the thorax (Yes=1, No=0) | 5 minutes | 
| COVID19 Diagnosis by swab test | COVID19 Diagnosis by swab test (Yes=1, No=0) | 5 minutes | 
| COVID 19 Diagnosis by antibody test | COVID 19 Diagnosis by antibody test (Yes=1, No=0) | 5 minutes | 
| COVID19 symptoms - dry cough | dry cough (Yes=1, No=0) | 5 minutes | 
| COVID19 symptoms - fever | fever (Yes=1, No=0) | 5 minutes | 
| COVID19 symptoms - myalgia | myalgia (Yes=1, No=0) | 5 minutes | 
| COVID19 symptoms - anosmia | anosmia (Yes=1, No=0) | 5 minutes | 
| COVID19 symptoms -respiratory distress | respiratory distress (Yes=1, No=0) | 5 minutes | 
| Treatment for COVID19 - Plaquenil | Plaquenil (Yes=1, No=0) | 5 minutes | 
| Treatment for COVID19 - Antivirals | Antivirals (Yes=1, No=0) | 5 minutes | 
| Need for intubation | Need for intubation (Yes=1, No=0) | 5 minutes | 
| Death | Mortality (Yes=1, No=0) | 5 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Age | Patient age | 5 minutes | 
| Gender | Patient gender | 5 minutes | 
| Ethnicity | Patient ethnicity | 5 minutes | 
| BMI | Patient Body Mass Index | 5 minutes | 
| Comorbidities | Patient comorbidities | 5 minutes |