Effect of COVID-19 Pandemic on Presentation and Outcomes of Gallstone Disease
Abstract:
Objective
To determine the effect of the COVID-19 pandemic on the presentation and outcomes of gallstone disease, and to compare these findings with the pre-COVID period.
Methods
This retrospective observational study was conducted in the Surgical Emergency Department of Holy Family Hospital, Rawalpindi. Patient data was collected for those who presented to the Emergency Department (ED) from April to August 2020 (Group I) and compared with those who presented during the same months in 2019 (Group II). A higher number of patients presented with complicated gallstone disease during the COVID-19 pandemic compared to the pre-COVID period. COVID-19 was identified as an independent risk factor for the presentation of gallstone disease complications in the ED.
Results
A total of 108 patients (53%) were included in Group I, and 95 patients (47%) in Group II. More patients were admitted through the ED in Group I compared to Group II (63 [58%] vs. 40 [42%], p = 0.003). The duration of symptoms prior to ED presentation was significantly longer in Group I than in Group II (3.55 ± 1.45 vs. 2.86 ± 1.32 days, p = 0.001). Furthermore, patients in Group I presented with more severe disease, as assessed by the Tokyo criteria, and the number of cases with complicated gallstone disease was significantly higher in Group I (p = 0.01).
Conclusion
During the COVID-19 pandemic, patients were hesitant to seek medical attention for elective surgeries due to fear of infection. Additionally, the suspension of elective procedures during lockdown contributed to an increase in emergency admissions for severe and complicated gallstone disease. These findings suggest that COVID-19 is an independent risk factor for the delayed presentation and increased complication rate of gallstone disease in the Emergency Department.