SARS-CoV-2 has had an unprecedented effect worldwide. We aim to look at the indirect consequences on emergency surgery and how emergency anaesthesia was impacted. Specifically we look at how the COVID-19 pandemic has affected:

• - Volume and type of cases in emergency theatre
• - Anaesthetic techniques
• - Post-operative length of hospital stay

 A retrospective analysis of emergency cases over 2 time periods in a London District General Hospital:

• ‘Non-COVID period’ or 18/3/2019 – 17/5/2019
• ‘COVID period’ or 18/3/2020 – 17/5/2020

We collected data using the ‘Surginet’ on our ‘Electronic Patient Records’ program. We included all emergency and trauma cases for patients of all ages. We excluded all planned cancer, fertility, termination of pregnancy and emergency obstetric cases.

In the COVID period there was a reduction in the total number of emergency cases across most surgical subspecialties. In the COVID period 14.7% of cases were performed under regional anaesthesia compared to 1.0% in the Non-COVID period. The post-operative length of stay was 2.5 days in 2020 compared to 4.6 in 2019 (p=0.09), (see Table 1).

We postulate that the reduction in surgical emergency cases could be explained by the shift to conservative management, where possible. The change in practice reduces patient exposure to COVID and anaesthetic risk. Although not statistically significant, the reduction in LOS may be explained partly by the increased use of regional anaesthesia. 

Going forward these changes to surgical and anaesthetic practices may be beneficial in a ‘second wave’ to minimise patient exposure to the virus and burden on emergency theatres. However, this must be balanced against possible long-term surgical complications. The long-term effects of our change in practice are yet to be determined.

Table 1 - Comparison of Emergency Cases in COVID versus Non-COVID period