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COVID-19 Pandemic and the Cholecystitis Experience at a Major Urban Safety-Net Hospital.
Vallès, Katherine F; Neufeld, Miriam Y; Caron, Elisa; Sanchez, Sabrina E; Brahmbhatt, Tejal S.
  • Vallès KF; Drexel University College of Medicine, Philadelphia, Pennsylvania.
  • Neufeld MY; Boston University School of Medicine, Boston, Massachusetts; Boston Medical Center, Department of General Surgery, Boston, Massachusetts.
  • Caron E; Boston University School of Medicine, Boston, Massachusetts.
  • Sanchez SE; Boston University School of Medicine, Boston, Massachusetts; Boston Medical Center, Department of General Surgery, Boston, Massachusetts.
  • Brahmbhatt TS; Boston University School of Medicine, Boston, Massachusetts; Boston Medical Center, Department of General Surgery, Boston, Massachusetts. Electronic address: tejal.brahmbhatt@bmc.org.
J Surg Res ; 264: 117-123, 2021 08.
Article in English | MEDLINE | ID: covidwho-1164148
ABSTRACT

BACKGROUND:

Acute cholecystitis is a common reason for emergency general surgery admission. The declaration of the COVID-19 pandemic may have resulted in treatment delays and corresponding increases in severity of disease. This study compared cholecystitis admissions and disease severity pre- and postdeclaration of pandemic. MATERIALS AND

METHODS:

Retrospective review of adult acute cholecystitis admissions (January 1,2020-May 31, 2020). Corresponding time periods in 2018 and 2019 comprised the historical control. Difference-in-differences analysis compared biweekly cholecystitis admissions pre- and postdeclaration in 2020 to the historical control. Odds of increased severity of disease presentation were assessed using multivariable logistic regression.

RESULTS:

Cholecystitis admissions decreased 48.7% from 5.2 to 2.67 cases (RR 0.51 [0.28,0.96], P = 0.04) following pandemic declaration when comparing 2020 to historical control (P = 0.02). After stratifying by severity, only Tokyo I admissions declined significantly postdeclaration (RR 0.42 [0.18,0.97]), when compared to historical control (P = 0.02). There was no change in odds of presenting with severe disease after the pandemic declaration (aOR 1.00 [95% CI 0.30, 3.38] P < 0.99) despite significantly longer lengths of symptoms reported in mild cases.

CONCLUSIONS:

Postpandemic declaration we experienced a significant decrease in cholecystitis admissions without corresponding increases in disease severity. The pandemic impacted healthcare-seeking behaviors, with fewer mild presentations. Given that the pandemic did not increase odds of presenting with increased severity of disease, our data suggests that not all mild cases of cholecystitis progress to worsening disease and some may resolve without medical or surgical intervention.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Severity of Illness Index / Patient Acceptance of Health Care / Cholecystitis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Surg Res Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Severity of Illness Index / Patient Acceptance of Health Care / Cholecystitis / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Qualitative research Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: J Surg Res Year: 2021 Document Type: Article