The impact of COVID-19 pandemic on the mortality and morbidity of patients undergoing trauma surgery: a report from the UK Corona TRAUMA Surge (UKCoTS) study.

PURPOSE: To assess the impact of the COVID-19 pandemic on the outcomes of the patients who underwent trauma surgery during the peak of the pandemic. METHODS: The UKCoTS collected the postoperative outcomes of consecutive patients who underwent trauma surgery across 50 centres during the peak of the pandemic (April 2020) and during April 2019. RESULTS: Patients who were operated on during 2020 were less likely to be followed up within a 30-day postoperative period (57.5% versus 75.6% p <0.001). The 30-day mortality rate was significantly higher during 2020 (7.4% versus 3.7%, p <0.001). Likewise, the 60-day mortality rate was significantly higher in 2020 than in 2019 (p <0.001). Patients who were operated on during 2020 had lower rates of 30-day postoperative complications (20.7% versus 26.4%, p <0.001). CONCLUSIONS: Postoperative mortality was higher during the first wave of the COVID-19 pandemic compared to the same period in 2019, but with lower rates of postoperative complications and reoperation.

Global impact of COVID-19 on surgeons and team members (GlobalCOST): a cross-sectional study.

OBJECTIVES: To investigate the impact of COVID-19 on the well-being of surgeons and allied health professionals as well as the support provided by their institutions. DESIGN: This cross-sectional study involved distributing an online survey through medical organisations, social media platforms and collaborators. SETTING: It included all staff based in an operating theatre environment around the world. PARTICIPANTS: 1590 complete responses were received from 54 countries between 15 July and 15 December 2020. The average age of participants was 30-40 years old, 64.9% were men and 32.5% of a white ethnic background. 79.5% were surgeons with the remainder being nurses, assistants, anaesthetists, operating department practitioners or classified other. MAIN OUTCOME MEASURES: Participants that had experienced any physical illness, changes in mental health, salary or time with family since the start of the pandemic as well as support available based on published recommendations. RESULTS: 32.0% reported becoming physically ill. This was more likely in those with reduced access to personal protective equipment (OR 4.62; CI 2.82 to 7.56; p<0.001) and regular breaks (OR 1.56; CI 1.18 to 2.06; p=0.002). Those with a decrease in salary (29.0%) were more likely to have an increase in anxiety (OR 1.50; CI 1.19 to 1.89; p=0.001) and depression (OR 1.84; CI 1.40 to 2.43; p<0.001) and those who spent less time with family (35.2%) were more likely to have an increase in depression (OR 1.74; CI 1.34 to 2.26; p<0.001). Only 36.0% had easy access to occupational health, 44.0% to mental health services, 16.5% to 24/7 rest facilities and 14.2% to 24/7 food and drink facilities. Fewer measures were available in countries with a low Human Development Index. CONCLUSIONS: This work has highlighted a need and strategies to improve conditions for the healthcare workforce, ultimately benefiting patient care.

Global impact of COVID-19 on surgeons and team members (GlobalCOST): a cross-sectional study

Objectives To investigate the impact of COVID-19 on the well-being of surgeons and allied health professionals as well as the support provided by their institutions. Design This cross-sectional study involved distributing an online survey through medical organisations, social media platforms and collaborators. Setting It included all staff based in an operating theatre environment around the world. Participants 1590 complete responses were received from 54 countries between 15 July and 15 December 2020. The average age of participants was 30–40 years old, 64.9% were men and 32.5% of a white ethnic background. 79.5% were surgeons with the remainder being nurses, assistants, anaesthetists, operating department practitioners or classified other. Main outcome measures Participants that had experienced any physical illness, changes in mental health, salary or time with family since the start of the pandemic as well as support available based on published recommendations. Results 32.0% reported becoming physically ill. This was more likely in those with reduced access to personal protective equipment (OR 4.62;CI 2.82 to 7.56;p<0.001) and regular breaks (OR 1.56;CI 1.18 to 2.06;p=0.002). Those with a decrease in salary (29.0%) were more likely to have an increase in anxiety (OR 1.50;CI 1.19 to 1.89;p=0.001) and depression (OR 1.84;CI 1.40 to 2.43;p<0.001) and those who spent less time with family (35.2%) were more likely to have an increase in depression (OR 1.74;CI 1.34 to 2.26;p<0.001). Only 36.0% had easy access to occupational health, 44.0% to mental health services, 16.5% to 24/7 rest facilities and 14.2% to 24/7 food and drink facilities. Fewer measures were available in countries with a low Human Development Index. Conclusions This work has highlighted a need and strategies to improve conditions for the healthcare workforce, ultimately benefiting patient care.

Impact of the first wave of COVID-19 on the ERCP services in a single secondary endoscopy unit at the North of England: a retrospective analysis of the endoscopy database at royal lancaster infirmary

BackgroundBritish Society of Gastroenterology (BSG) recommended that the endoscopy units to perform ERCP during the COVID-19 pandemic for obstructive biliary pathologies in an emergency. We aim to assess the local performance of ERCP during the COVID-19 first wave at our local endoscopy centre.MethodsAll ERCP procedures performed from January 2020 to Jun 2020 were retrospectively assessed and compared with procedures performed between January-Jun 2019 at Royal Lancaster Infirmary. Indications of ERCP, success rate, and complications were studied separately. Correlation analysis was conducted using Spearman’s rank correlation coefficient. The binary logistic regression model was carried out to compute factors associated with successful ERCP. The significance is established when the two-sides P-value < 0.05. Statistical analysis was performed using SPSS software version 25 for Windows (SPSS Inc., Chicago, IL, USA) (Corporation, 2017).ResultsFrom 281 patients, 60.14% and 38.14% patients were presented for ERCP procedures before and after COVID-19 period respectively. Higher proportion of patients was presented with liver dysfunction before pandemic period as compared to pandemic period (P<0.005) and use of antibiotics was significantly higher in pandemic period (P<0.05). the success rate of ERCP procedure was higher before emergence of the pandemic and lesser during the COVID-19 first wave as 86.39% and 77.67% respectively but the results were insignificant (P=0.07). A statistically significant but negative correlation was observed between cholangitis and stent insertion with ERCP success and positive correlation between sphincterotomy and ERCP success as (r=-0.129, P=0.030), (r= -0.172, P=0.004) and (r= 0.232, P<0.001) respectively. In binary logistic regression analysis, sphincterotomy (β =2.800, P=0.028) and stent insertion (β =0.852, P=0.046) were statistically significant predictors of ERCP outcomes. There was no statistically significant impact of cholangitis in the success of ERCP (β =1.672, P=0.109).ConclusionCOVID-19 pandemic significantly reduced ERCP procedures and success rate was also lowered due to restriction on endoscopic services in UK and all over the world. The endoscopic services can be resumed subject to specific SOPs to be followed in endoscopic units without affecting the safety of staff and patients.