The Impact of COVID-19 on Surgical Emergencies: Systematic Review/Meta-Analysis

Background: The COVID-19 pandemic, which originated in Wuhan, China, has caused widespread human distress, eco-nomic instability, and health system disruptions worldwide and is responsible for the 2019–20 pandemic. SARS-CoV-2 affects the respiratory tract, organs and systems, causing symptoms ranging from asymptomatic to severe illness. Aim of Study: To evaluate the impact of COVID-19 on surgical emergencies(admissions) and surgical outcomes (mor-tality rates, post-operative complications, ICU admissions and length of stay). Material and Methods: A literature search was conducted between March 2020 and August 2022 and yielded 512 articles after ranking articles by authors and year of publication. For further steps of data collection, analysis and reporting, only ar-ticles that met the inclusion criteria were included (18 articles in total). Results: The results showed that the COVID-19 pandemic resulted in a significant increase in the complication rate among the pandemic group in comparison with the pre-pandemic group (RR 1.60, 95% CI 1.39–1.85), including a surge in mor-tality rate (RR 1.513, 95% CI: 1.137–2.014), and a decline by almost (22.8%) in admission number to the ED among the pandemic group. However, it has no influence on the following surgical patient outcomes: LOS in the hospital or ICU admis-sion. Furthermore, a subgroup analysis among patients infected with COVID-19 vs. COVID-negative patients also shows an increase in mortality rate (RR 3.895, 95% CI 1.490–10.183) and a higher median length of stay during hospitalization. Conclusion: The COVID-19 pandemic has had a sig-nificant impact on surgical outcomes. This unfavorable effect could play a crucial role in improving the proper implemen-tation of strategies and safety precautions during a pandemic, which could contribute to a better diagnosis in these patients.