Outcomes after emergency abdominal surgery in COVID-19 patients at a referral center in Brazil

Rasslan, Roberto; dos Santos, Jones Pessoa; Menegozzo, Carlos Augusto Metidieri; Pezzano, Alvaro Vicente Alvarez; Lunardeli, Henrique Simonsen; dos Santos Miranda, Jocielle; Utiyama, Edivaldo Massazo; Damous, Sérgio Henrique Bastos

PURPOSE: COVID-19 is associated with high morbidity and mortality in patients undergoing surgery. Contrary to elective procedures, emergency operations should not be postponed. We aim to evaluate the profile and outcomes of COVID-19 patients who underwent emergency abdominal surgery. METHODS: We performed a retrospective analysis of perioperative data of COVID-19 patients undergoing emergency surgery from April 2020 to August 2020. RESULTS: Eighty-two patients were evaluated due to abdominal complaints, yielding 22 emergency surgeries. The mean APACHE II and SAPS were 18.7 and 68, respectively. Six patients had a PaO(2)/FiO(2) lower than 200 and more than 50% of parenchymal compromise on chest tomography. The most common indications for emergency surgery were hernias (6; 27.2%). The median length of stay was 30 days, and only two patients required reoperation. Postoperatively, 10 (43.3%) patients needed mechanical ventilation for a mean of 6 days. The overall mortality rate was 31.8%. CONCLUSION: Both postoperative morbidity and mortality are high in COVID-19 patients with respiratory compromise and abdominal emergencies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13304-021-01007-5.