Impact of corona pandemic on paediatric surgical services: an institutional experience
DOI:
https://doi.org/10.18203/2349-2902.isj20213999Keywords:
Corona virus, Lockdown, Pandemic, Paediatric surgeryAbstract
Background: Corona-virus disease pandemic affected the health-care delivery at all institutions worldwide. Analysis of institutional data regarding management of surgical paediatric patients would reflect the impact and challenges which this pandemic brought by affecting the only functioning Paediatric surgery center in a poor province of a developing country. Objective was assessment of the impact of the COVID pandemic on the paediatric surgical services of a tertiary care center.
Methods: Retrospective data of all patients operated at the only functioning tertiary center in Bihar with pediatric surgical services during the COVID-related lockdown period were collected and compared to the immediate pre-lockdown period and after the lockdown period. The impact of following the guidelines for surgery during this period was studied.
Results: Both the number (0.8 cases/day) and types of patients operated in the lockdown period varied from the pre-lockdown period (3.62 cases/day). Elective cases were most significantly affected; neonatal, traumatic and malignancy cases could not be deferred and were therefore managed during the lockdown. Although the number of surgeries increased in unlock-down period (2.07 cases/day) and reached to a peak of 2.99 cases/day in the normal period between two phases of the pandemic; this increase was short-lived as the second phase of the pandemic again severely impacted the surgical care (1.38 cases/day).
Conclusions: Corona pandemic severely impacted both the number and types of patients operated. Strict adherence to the protocol delayed emergency treatment and increased the cost of definitive management.
References
World Health Organisation (WHO). Coronavirus disease (COVID-19) outbreak. Available at: https://www.who.int/emergencies/ diseases/novel-coronavirus-2019. Accessed on 13 March 2021.
Davenport M, Pakarinen MP, Tam P, Laje P, Holcomb GW. The COVID 19 crisis and its implication for paediatric surgeons. J Paediatr Surg. 2020;55:785 8.
Liu W, Zhang Q, Chen J, Xiang R, Song H, Shu S, et al. Detection of Covid 19 in children in early January 2020 in Wuhan, China. N Engl J Med. 2020;382:1370 1.
LuX, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS CoV 2 infection in children. N Engl J Med. 2020;382:1663 5.
American College of Surgeons. 2020. COVID-19 Guidelines for Triage of Pediatric Surgery Patients. Available at: https://www.e-fjs.org. Accessed on 14 March 2021.
EAU Guidelines Office Rapid Reaction Group. An Organisation wide Collaborative Effort to Adapt the EAU Guidelines Recommendations to the COVID 19 Era. Available at: https://uroweb.org/guideline/ covid 19 recommendations/. Accessed on 13 March 2021.
American College of Surgeons. COVID 19: Guidance for triage of non Emergent Surgical Procedures. Available at: https://www. facs.org/aboutacs/covid 19/information for surgeons/triage. Accessed on 13 March 2021.
Government of India. Revised Strategy of COVID-19 testing in India. Available at: https://mohfw.gov.in/. Accessed on 13 March 2021.
Bloem BR, Dorsey ER, Okun MS. The coronavirus disease 2019 crisis as catalyst for telemedicine for chronic neurological disorders. JAMA Neurol. 2020;77:927-8.
Smith AC, Thomas E, Snoswell CL, Haydon H, Mehrotra A, Clemensen J, et al. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID 19). J Telemed Telecare. 2020;26:309 13.
Al Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C, et al. Impact of the coronavirus (COVID 19) pandemic on surgical practice Part 2 (surgical prioritisation). Int J Surg. 2020;79:233 48.
American College of Surgeons Committee on Trauma. Maintaining Trauma Center Access & Care during the COVID 19 Pandemic: Guidance Document for Trauma Medical Directors. 2020. Available at: https://www.facs.org/quality programs/trauma/ maintaining access. Accessed on 14 March 2021.
NHS England. Clinical Guide for the Management of Trauma and Orthopaedic Patients during the Coronavirus Pandemic. 2020. Available at: https://www.england.nhs.uk/coronavirus/wp-content/uploads/ sites/52/2020/03/C0274-Specialty-guide-Orthopaedic-trauma-v214-April.pdf. Accessed on 14 March 2021.
Bartlett DL, Howe JR, Chang G, Crago A, Hogg M, Karakousis G, et al. Management of cancer surgery cases during the COVID 19 pandemic: Considerations. Ann Surg Oncol. 2020;27:1717 20.
Guanyu Y, Zheng L, Wei Z. Several suggestion of operation for colorectal cancer under the outbreak of Corona Virus Disease 19 in China. Chin J Gastrointest Surg. 2020;23:9 11.
Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158:1831-3.
Zheng MH, Boni L, Fingerhut A. Minimally invasive surgery and the novel coronavirus outbreak: Lessons learned in China and Italy. Ann Surg. 2020;272:5-6.
Vigneswaran Y, Prachand VN, Posner MC, Matthews JB, Hussain M. What is the appropriate use of laparoscopy over open procedures in the current COVID 19 climate? J Gastrointest Surg. 2020;24:1686 91.
Mallick R, Odejinmi F, Clark TJ. Covid 19 pandemic and gynaecological laparoscopic surgery: Knowns and unknowns. Facts Views Vis Obgyn. 2020;12:3 7.
