P13 Abdominal Surgery during the COVID-19 Pandemic: A Multicentre Audit

The threshold for surgery has increased during the COVID-19 pandemic. A widely cited Chinese study (n = 34) reported postoperative COVID-19 pneumonia and mortality rates of 100% and 21% respectively [1]. This audit assessed outcomes after abdominal surgery across three hospitals within Mid & South Essex NHS Foundation Trust.

Patients undergoing abdominal surgery at Basildon University Hospital, Mid Essex Hospital and Southend University Hospital between 1st March and 27th April 2020 were included. Obstetric, gynaecological, vascular, inguinal/femoral hernia, and skin operations were excluded. Electronic data collection was supplemented by telephone follow-up.

306 patients were included. The median age was 57 years. 148 (48.4%) were female. 156 (51.0%) and 150 (49.0%) patients underwent elective and emergency surgery respectively. The preoperative and postoperative SARS-CoV-2 rates (based on RT-PCR or imaging) were 0.3% (n = 1) and 4.6% (n = 14) respectively. 84.6% (n = 259) did not have RT-PCR tests. All-cause 30-day mortality was 3.6% (n = 11). Amongst patients with SARS-CoV-2, mortality was 50% (7/14), occurring only after emergency surgery. Elective (vs. emergency) surgery was associated with lower postoperative SARS-CoV-2 (0.6% vs. 8.7%; p < 0.001) and mortality (0.6% vs. 6.7%; p = 0.005). At follow-up, 79.1% (242/306) of patients responded, most (85.1%; 206/242) without major clinical issue.

Local SARS-CoV-2 and mortality rates are lower than previously reported [1]. Perioperative COVID-19 carries a high mortality risk. We recommend perioperative SARS-CoV-2 testing for all patients and cohorting by infection status.

1. Lei et al., Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection, EClinicalMedicine(2020), https://doi.org/10.1016/j.eclinm.2020.100331