The impact of the COVID-19 pandemic on emergency general surgery: a retrospective study.

BACKGROUND: The COVID-19 pandemic has affected healthcare systems worldwide. The effect of the pandemic on emergency general surgery patients remains unknown. OBJECTIVE: To reveal the effects of the COVID-19 pandemic on mortality and morbidity among emergency general surgery cases. DESIGN AND SETTING: Data on patients who were admitted to the emergency department of a tertiary hospital in Samsun, Turkey, and had consultations at the general surgery clinic were analyzed retrospectively. METHODS: Our study included comparative analysis on two groups of patients who received emergency general surgery consultations in our hospital: during the COVID-19 pandemic period (Group 2); and on the same dates one year previously (Group 1). RESULTS: There were 195 patients in Group 1 and 132 in Group 2 (P < 0.001). While 113 (58%) of the patients in Group 1 were women, only 58 (44%) were women in Group 2 (P = 0.013). Considering all types of diagnosis, there was no significant difference between the two groups (P = 0.261). The rates of abscess and delayed abdominal emergency diseases were higher in Group 2: one case (0.5%) versus ten cases (8%); P < 0.001. The morbidity rate was higher in Group 2 than in Group 1: three cases (1.5%) versus nine cases (7%); P = 0.016. CONCLUSIONS: The COVID-19 pandemic has decreased the number of unnecessary nonemergency admissions to the emergency department, but has not delayed patients' urgent consultations. The pandemic has led surgeons to deal with more complicated cases and greater numbers of complications.

The impact of the COVID-19 pandemic on emergency general surgery: a retrospective study

ABSTRACT BACKGROUND: The COVID-19 pandemic has affected healthcare systems worldwide. The effect of the pandemic on emergency general surgery patients remains unknown. OBJECTIVE: To reveal the effects of the COVID-19 pandemic on mortality and morbidity among emergency general surgery cases. DESIGN AND SETTING: Data on patients who were admitted to the emergency department of a tertiary hospital in Samsun, Turkey, and had consultations at the general surgery clinic were analyzed retrospectively. METHODS: Our study included comparative analysis on two groups of patients who received emergency general surgery consultations in our hospital: during the COVID-19 pandemic period (Group 2); and on the same dates one year previously (Group 1). RESULTS: There were 195 patients in Group 1 and 132 in Group 2 (P < 0.001). While 113 (58%) of the patients in Group 1 were women, only 58 (44%) were women in Group 2 (P = 0.013). Considering all types of diagnosis, there was no significant difference between the two groups (P = 0.261). The rates of abscess and delayed abdominal emergency diseases were higher in Group 2: one case (0.5%) versus ten cases (8%); P < 0.001. The morbidity rate was higher in Group 2 than in Group 1: three cases (1.5%) versus nine cases (7%); P = 0.016. CONCLUSIONS: The COVID-19 pandemic has decreased the number of unnecessary nonemergency admissions to the emergency department, but has not delayed patients' urgent consultations. The pandemic has led surgeons to deal with more complicated cases and greater numbers of complications.

Gross pathology, blood chemistry, lipid and peroxide contents in rainbow trout ( Oncorhynchus mykiss Walbaum) affected by experimental Arcobacter cryaerophilus infection at low water temperature.

Arcobacter cryaerophilus was isolated from naturally infected rainbow trout ( Oncorhynchus mykiss Walbaum), and its pathogenicity was tested by intramuscular injection using healthy 1-year-old rainbow trout under cold-water conditions (at 5 degrees C). The lethal dosage of 50% end point (LD 50 ) for A. cryaerophilus was calculated as 7.79 x 10 5 viable cells. Experimental infection caused gross clinical abnormalities such as fallen scales, exophthalmia, oedema in injection region and at the base of fins, pale gills, kidney necrosis, hyperaemic areas in pale liver, haemorrhagic spots in heart, elongated spleen and swollen gallbladder. Activities of aspartate aminotransferase and alkaline phosphatase, and concentrations of glucose, total protein, albumin, cholesterol, triglyceride and calcium in the serum of the experimentally infected rainbow trout were significantly decreased compared with the healthy fish. Positive correlations were observed among blood parameters. Total lipid weights increased in the brain, muscle and liver tissues of infected fish and dropped in the gill and spleen tissues. Lipid peroxide contents in the brain, liver, kidney, spleen, muscle and gill tissues of infected rainbow trout were significantly higher than in healthy animals. The present work shows that A. cryaerophilus can be moderately virulent for rainbow trout at low water temperature, and changes in lipid and lipid peroxide contents of tissues and blood indices can highlight barely detectable effects of A. cryaerophilus infection in rainbow trout under laboratory conditions. However, the application of these indices in farm biomonitoring using rainbow trout will need more detailed studies and a careful consideration of the environmental parameters.