The impact of the Covid-19 pandemic on emergency surgery in a tertiary hospital in Jordan. A cross sectional study

BACKGROUND: Since the emergence of COVID-19 pandemic, governments around the world reacted by implementing curfews and sometimes nation-wide lockdowns intended to control the spread of the disease and help the already overwhelmed healthcare systems from imminent collapse. The Jordanian government was one of those countries that implemented a complete nation-wide lockdown which lasted for 3 months during the peak months of 2020. The aim of this study is to shed the light on the impact of this lockdown on the surgical emergency practice at a tertiary referral center in Amman, the capital of Jordan. METHODS: A retrospective review of the medical records of the patients who were admitted to the hospital through the emergency department over the lock-down months in 2020 and compare them to the records of the patients admitted within the same period in 2019. RESULTS: A total of 143 patients were admitted in the 2020 group, compared to 201 patients in the 2019 group, marking a 28% reduction in admission rate. The average duration of symptoms before the ER visit was significantly longer in the 2020 period compared to 2019 (95.32 ± 148.62 min, 57 ± 64.4 min respectively, p = 0.01) which resulted in a Significant increase in the ICU admission in the same period (P=.00001). As for the type of management, there was no difference between the two groups with similar percentage of surgeries performed in the two periods (p = 0.333). Additionally, the average length of stay did not also differ (p = 0.141). CONCLUSION: The COVID-19 pandemic has negatively affected the health care systems around the world to the point of collapse in some countries. This study has demonstrated its effects on the emergency surgery practice at our institution which was mainly related to the delay in getting medical care caused by the strict lock-down laws implemented in the country. Thus, we recommend that special measures should be taken to improve the access to medical care during future events that may require limiting the movement of people and vehicles in the country.