Acute abdomen in patients with SARS-CoV-2 infection or co-infection
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ORIGINAL ARTICLE
Acute abdomen in patients with SARS-CoV-2 infection or co-infection Barbara Seeliger 1,2 Patrick Pessaux 1,2,3
&
Guillaume Philouze 2
&
Zineb Cherkaoui 1,2,3
&
Emanuele Felli 2,3
&
Didier Mutter 1,2
&
Received: 25 June 2020 / Accepted: 23 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Patients with an acute abdomen require emergency surgery. SARS-CoV-2 infection can affect multiple organ systems, including the digestive tract. Little is known about the consequences of COVID-19 infection in emergency surgical patients. Methods Perioperative data for COVID-19 patients undergoing emergency surgery from March 1, 2020, to May 23, 2020 were collected prospectively (NCT04323644). Results During this period, 215 patients underwent surgery, including 127 patients in an emergency setting, of whom 13 (10.2%) had COVID-19. Two scenarios were identified: (a) patients who were admitted to a hospital for an acute surgical condition with a concomitant diagnosis of COVID-19, and (b) patients with severe COVID-19 developing acute abdominal pathologies during their hospital stay. When compared with those in group B, patients in group A globally recovered better, with a lower mortality rate (14.3% vs. 33.3%), lower ARDS rate (28.5% vs. 50.0%), less rates of preoperative invasive ventilation (14.3% vs. 50.0%) and postoperative invasive ventilation (28.5% vs. 100.0%), and a shorter duration of invasive ventilation. No causality between SARS-CoV-2 infection and gastrointestinal affliction was found. Conclusion Our observations underline that mild co-infection with COVID-19 did not result in more complications for emergency abdominal surgery. Howe, an acute abdomen during severe COVID-19 infection was part of an unfavorable prognosis. Keywords COVID-19 . Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . Acute abdomen . Laparoscopy . Abdominal surgery
Introduction Most of the elective interventions were descheduled as of March 12, 2020. Due to the magnitude of the COVID-19 pandemic in the North-Eastern Grand Est region of France, only emergency surgery was maintained in our department from March 24 to April 24, 2020. Patients with an acute abdomen require emergency abdominal surgery, including with a concomitant COVID-19 infection [1, 2]. The consequences of the COVID-19 infection in patients * Patrick Pessaux [email protected] 1
IHU-Strasbourg, Institute of Image-Guided Surgery, Strasbourg, France
2
Department of Visceral and Digestive Surgery, Nouvel Hopital Civil, Hôpitaux Universitaires de Strasbourg, 1 Place de l’Hôpital, 67091 Strasbourg Cedex, France
3
INSERM U1110, Institut de Recherche Sur Maladies Virales et Hépatiques, Strasbourg, France
undergoing emergency surgery are still poorly known [2]. In severely affected COVID-19 patients, the incidence of gastrointestinal complications is high (73.8%), including the occurrence of gastrointestinal ischemia (3.8%) [3]. The factors accountable for this digestive involvement are not
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