Aviran Eyal, Laks Shachar, Benvenisti Haggai, Khalilieh Saed, Assaf Dan, Aviran Nimrod, Hazzan David, Klein Yoram, Cohen Amir, Gutman Mordechai, Nissan Aviram, Segev Lior
Department of General and Oncological Surgery C, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2020 Nov;11(22):673-679.
As part of the effort to control the coronavirus disease-19 (COVID-19) outbreak, strict emergency measures, including prolonged national curfews, have been imposed. Even in countries where healthcare systems still functioned, patients avoided visiting emergency departments (EDs) because of fears of exposure to COVID-19.
To describe the effects of the COVID-19 outbreak on admissions of surgical patients from the ED and characteristics of urgent operations performed.
A prospective registry study comparing all patients admitted for acute surgical and trauma care between 15 March and 14 April 2020 (COVID-19) with patients admitted in the parallel time a year previously (control) was conducted.
The combined cohort included 606 patients. There were 25% fewer admissions during the COVID-19 period (P < 0.0001). The COVID-19 cohort had a longer time interval from onset of symptoms (P < 0.001) and presented in a worse clinical condition as expressed by accelerated heart rate (P = 0.023), leukocyte count disturbances (P = 0.005), higher creatinine, and CRP levels (P < 0.001) compared with the control cohort. More COVID-19 patients required urgent surgery (P = 0.03) and length of ED stay was longer (P = 0.003).
During the COVID-19 epidemic, fewer patients presented to the ED requiring acute surgical care. Those who did, often did so in a delayed fashion and in worse clinical condition. More patients required urgent surgical interventions compared to the control period. Governments and healthcare systems should emphasize to the public not to delay seeking medical attention, even in times of crises.
作为控制新型冠状病毒肺炎（COVID-19）疫情工作的一部分，已实施了包括延长全国宵禁在内的严格紧急措施。即使在医疗系统仍在运转的国家，患者也因担心感染COVID-19而避免前往急诊科（ED）就诊。
描述COVID-19疫情对急诊科手术患者入院情况及所进行的紧急手术特征的影响。
进行了一项前瞻性登记研究，比较了2020年3月15日至4月14日期间因急性外科和创伤护理入院的所有患者（COVID-19组）与前一年同期入院的患者（对照组）。
合并队列包括606例患者。COVID-19期间的入院人数减少了25%（P < 0.0001）。与对照组相比，COVID-19组从症状出现到入院的时间间隔更长（P < 0.001），且临床状况更差，表现为心率加快（P = 0.023）、白细胞计数紊乱（P = 0.005）、肌酐和CRP水平更高（P < 0.001）。更多COVID-19患者需要紧急手术（P = 0.03），且在急诊科的停留时间更长（P = 0.003）。
在COVID-19疫情期间，前往急诊科需要急性外科护理的患者减少。前来就诊的患者往往就诊延迟且临床状况更差。与对照期相比，更多患者需要紧急手术干预。政府和医疗系统应向公众强调，即使在危机时期也不要延迟寻求医疗帮助。
