Simple and Effective Primary Assessment of Emergency Patients in a COVID-19 Outbreak Area: A Retrospective, Observational Study

Background: The rapid spread of COVID-19 has expanded into a pandemic, for which the main containment strategies to reduce transmission are social distancing and isolation of ill persons Thousands of medical staff have been infected worldwide Coronavirus testing kits have been in short supply, and early diagnostic reagents did not have high sensitivity The aim of this study was to describe the characteristics of patients requiring emergency surgery in a COVID-19 outbreak area Methods: We assessed medical data regarding all patients who underwent emergency surgery at the main campus of Wuhan Union Hospital from January 23, 2020, to February 15, 2020 We classified patients based on suspicion of COVID-19 infection (suspected vs not suspected) before they were admitted to the operating room We used descriptive statistics to analyze the data Outcomes included the incidence of confirmed COVID-19 infection and length of stay, which were followed until March 25, 2020 Results: Among the 88 emergency patients included in this study, the mean age was 37 years Twenty-five patients presented with abnormalities observed on chest CT scans and 16 presented with fever The median wait time for surgery was one day The median preparation time and median time until short orientation memory concentration test (SOMCT) recovery from anesthesia were 44 0 min and 23 0 min, respectively The median postoperative length of stay was five days Compared with patients not suspected of COVID-19 infection, six patients were confirmed to be infected with COVID-19 in the suspected group No health care workers were infected during this study period Conclusion: Simple identification using temperature screening of patients, respiratory symptoms, and chest CT scans before being admitted for emergency surgery was rapid and effective Shortened contact times might reduce the risk of infection Additional investigations with larger samples and improved designs are needed to confirm these observations