COVID and its impact

COVID and its impact

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  ASingleCenterAuditofImpactofCOVID-19 onPediatricSurgicalCare Adnan Sayeed (MchResident) Departmentof PediatricSurgery, BangaloreMedicalCollege&ResearchInstitute
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  Introduction •Corona virus wasdeclared a pandemic and lockdown in India was declared on March 24th 2020. •The COVID 19 pandemic has caused huge disruption in the functioning of healthcare systems across the world.
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  Aim To compare PediatricSurgery practices, services in our institution, - Group 1: Pre COVID(September 2019–March 2020) - Group 2: Post COVID (October2020 –April 2021).
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  Materials and Methods •Weretrospectively compared pediatric surgery practices, including elective and emergency surgeries, and outpatient services. • Data was obtained from electronic database, OT, IP and OP register. •Effect of COVID status of child and guardian on scheduling of surgery and outcome of our protocol was looked at. •Data from April- September 2020 was not included as our hospital was declared a dedicated COVID centre
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  Protocol followed inour hospital Elective cases RTPCR (24hours) Operate Surgery postponed Positive Emergency cases Admit in isolation ward RA Tnegative RTPCR Operatein isolation OT Positive/reportawaited RTPCR negative operatedin regular ot Negative
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  Results Group 1 (Sep2019- March202 0) Group2 (Oct2020-April2021) Urology 14938 Digestive 225 71 CNS 36 19 Thoracic 59 15 MIS 128 27 Neonatal 121 30 Emergency 180 55 Minor 162 56 Total 1060 311
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  • Of the278 elective cases, -22 were rescheduled - due to caretaker being Positive or patient being primary contact. •Of the 55 emergency cases operated,1 was positive (retrospectively)
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  7 new bornsof COVID positive mothers needed surgical care. of these- - 3 developed NEC on initiation of feeds -1 developed Enterocutaneous fistula - 1 had TEF -1 had rachisis -1 underwent CDH repair 1 positive baby developed MIS-N and succumbed to internal bleeding and sepsis
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  A declining trendwas also noticed in our OPD and IPD numbers: OPD September 2019-March 2020: 8314 October 2020-April 2021: 4441 decline of 50% IPD September 2019- March 2020: 941 October 2020- April 2021: 555 decline of 40%
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  Conclusion •The pediatric surgerypractices have been severely affected. •There is an increased hospital stay and postponement of elective cases either due to exposure or patients/accompanying person being positive. •A fall in the number of emergency cases as well is something to be worried of.
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  References • Gunadi etal The Impact of COVID-19 pandemic onpediatric surgery practice: A cross-sectional study Annals of Medicine and Surgery Vol. 59, November 2020, Pages 96-100 • Ogundele IO, Alakaloko FM, Nwokoro CC, et al Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria:a national survey of paediatric surgeons BMJ Paediatrics Open 2020;4:e000732. doi: 10.1136/bmjpo-2020-000732 • Qazi, S.H., Saleem, A., Pirzada, A.N. et al. Challenges to delivering pediatric surgery services in the midst of COVID 19 crisis: experience from a tertiary care hospital of Pakistan. Pediatr Surg Int 36, 1267–1273 (2020).
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  Thank you