Impact of the COVID-19 pandemic on surgical procedures in Brazil: a descriptive study

Background: The COVID-19 pandemic has deeply affected medical practice, and changes in healthcare activities were needed to minimize the overload and avoid healthcare systems collapse. The aim of this study was to evaluate the impact of the pandemic on surgical procedures in Brazil. Materials and Methods: We conducted a descriptive study of the number of hospitalizations for surgical procedures in Brazil from 2016 to 2020. Data were collected from the Brazilian Department of Informatics of the Unified Health System (DATASUS). Analyzes were performed according to the type of procedure, geographical region, subgroups of surgical procedures, and the number of surgeries from 2020 were compared with the average from 2016 to 2019. Results: There were 4,009,116 hospitalizations for surgical procedures in the Brazilian Public Health System in 2020. When comparing it to the average of hospitalizations from 2016-2019, there was a decrease of 14.88% [95%IC (14.82-14.93)]. Decrease rates were 34.82% [95%IC (34.73-34.90)] for elective procedures and 1.11% [95%IC (1.07-1.13)] for urgent procedures. Decrease rates were similar in all the five regions of the country (average 14.17%). Surgical procedure subgroups with the highest decrease rates were endocrine gland surgery (48.03%), breast surgery (40.68%), oral and maxillofacial surgery (37.03%), surgery of the upper airways, face, head and neck (36.06%), and minor surgeries and surgeries of skin, subcutaneous tissue and mucosa (33.16%). Conclusion: The overload of healthcare facilities has demanded a reduction of non-urgent activities to prevent a collapse of healthcare systems, resulting in a decrease in elective surgeries. Recommendations about the performance of surgical procedures were made, and continuous refinements of these recommendations are encouraged.