The dramatic COVID‐19 outbreak in italy is responsible of a huge drop in urological surgical activity: A multicenter observational study

Rocco, B; Sighinolfi, MC; Sandri, M; Altieri, V; Amenta, M; Annino, F; Antonelli, A; Baio, R; Bertolo, R; Bocciardi, A; Borghesi, M; Bove, P; Bozzini, G; Cacciamani, G; Calori, A; Caffarelli, A; Celia, A; Cocci, A; Corsaro, A; Costa, G; Ceruti, C; Cindolo, L; Crivellaro, S; Dalpiaz, O; D’Agostino, D; Dall’Oglio, B; Falabella, R; Falsaperla, M; Finocchiaro, M; Gaboardi, F; Galfano, A; Gallo, F; Greco, F; Leonardo, C; Nucciotti, R; Oderda, M; Pagliarulo, V; Parma, P; Pastore, L; Pini, G; Porreca, A; Pucci, L; Schenone, M; Schiavina, R; Sciorio, C; Spirito, L; Tafuri, A; Terrone, C; Umari, P; Varca, V; Veneziano, D; Verze, P; Volpe, A; Micali, S; Berti, L; Zaramella, S; Minervini, A

OBJECTIVE: Italy is facing the COVID‐19 outbreak with an abrupt reorganization of its national health‐system, in order to augment care provision to symptomatic patients. The sudden shift of personnel and resources towards COVID‐19 care has led to the reduction of surgery, with possible severe drawbacks. The aim of the study is to describe the trend in surgical volume in urology, in Italy. MATERIALS AND METHODS: Thirty‐three urological units with physicians affiliated to the AGILE consortium were involved in a survey. Urologists were asked to report the amount of surgical elective procedures week‐by‐week, from the beginning of the emergency to the following month. RESULTS: The 33 hospitals involved in the study account, globally, for 22,945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed an overall amount of 1,213 procedures per week, half of which were oncological. One month later, the amount of surgery declined by 78%. Lombardy, the first region with positive‐cases, experienced a 94% reduction. The decrease in oncological and non‐oncological surgical activity was 35,9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions. CONCLUSION: Italy, the country with the highest fatality rate from COVID‐19, is experiencing a sudden decline in surgical activity. It is inversely related to the increase in COVID‐19 care, with potential harm particularly in the oncological field. The Italian experience can be helpful for future surgical pre‐planning in other countries not so hardly hit by the disease yet.