Outcomes of Operations for Suspected Adnexal Torsion during the COVID-19 Pandemic

Meller, N.; Levin, G.; Cohen, A.; Mohr-Sasson, A.; Berger, H.; Cohen, S. B.; Mashiach, R.; Meyer, R.

Study Objective To study the collateral effect of the actions taken to limit the spread of the COVID-19 pandemic by comparing the characteristics and outcomes of women who underwent laparoscopy for suspected adnexal torsion (AT) during the pandemic to pre-pandemic periods. Design A retrospective cohort study. Setting A tertiary, university affiliated medical center. Patients or Participants We included all women who underwent laparoscopy for suspected AT between March 2011 and February 2021. We compared the COVID-19 pandemic period, beginning at the first lockdown in Israel (March 15 2020, to February 8 2021, group 1) to a parallel period in 2019-2020 (group 2) and to a nine years period preceding the pandemic, between 3/2011-2/2020 (group 3). Interventions Diagnostic and operative laparoscopy. Measurements and Main Results Ninety-seven laparoscopies were performed in group 1, 82 in group 2, and 635 in group 3. Groups 1 and 2 were comparable in age, obstetrical history, sonographic characteristics of adnexa and clinical presentation. The rate of women presenting following IVF treatment was lower in group 1 [OR 95% CI 0.22 (0.06-0.86), p<0.023]. Time from admission to decision to operate was shorter in group 1 (162 vs. 232 minutes, p=0.028). In the comparison between groups 1 and 3, baseline characteristics were comparable. The rate of women presenting following IVF treatments was lower [OR 95% CI 0.15 (0.04-0.49), p<0.001], the time from admission to surgery was shorter (544 vs. 748 minutes, p=0.005), and the rate of surgically confirmed AT was lower [59 (60.8%) vs. 455 (71.7%), p=0.030, OR (95% CI) 0.61 (0.39-0.95)] in group 1. Conclusion Our data underline differences in the time from admission to surgery during the COVID-19 pandemic, and in the rate of women presenting with suspected AT following IVF treatments. These findings may reflect a change in medical resources during the pandemic.