Objective: To determine the effect of the COVID-19 pandemic on presentation and outcomes of gallstone disease and to compare them with the pre-COVID-19 period.

Methods: It is a retrospective observational study conducted in the surgical emergency department of holy family hospital, Rawalpindi. Data of all the patients presented to the emergency department (ED) from April to August 2020 (Group I) and in the same months of 2019 (Group II) were collected retrospectively. More patients presented with complicated gallstone disease in the emergency department during COVID-19 than in pre-COVID times. COVID-19 is an independent risk factor for presentation of patients in the emergency department with complications.

Results: There were 108 (53%) patients in Group I and 95 (47%) patients in Group II retained in the emergency department (ED) of General Surgery, holy family hospital, Rawalpindi. There were more patients admitted through the ED in Group I than in Group II (63[58%] vs 40[42%], p-value 0.003). In Group I patients, the duration of symptoms was prolonged before reaching the ED than in Group II (3.55+1.45 vs 2.86+1.32 days, p-value 0.001). Moreover, patients presented with more severe disease assessed by Tokyo criteria and the number of patients with complicated gallstone disease in Group I were also higher (p-value 0.01).

Conclusion: During the COVID-19 pandemic, patients were reluctant to attend hospitals for elective surgeries as a result of fear of COVID-19. Moreover, due to the cancellation of elective procedures during lockdown, there were more patients admitted through the Emergency Department with severe and complicated gallstone disease. Hence COVID-19 is an independent risk factor for presentation of patients in ED with complications.