COVID-19 Pandemic Acute-care Surgery Practice Survey Results from the Panamerican Trauma Society International Trauma Tele-Grand Rounds

Objective: As of June 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic has affected more than 7 million people worldwide, causing more than 400,000 deaths. Acute-care surgery approaches in times of the COVID-19 pandemic were discussed during the Panamerican Trauma Society International Trauma Tele-Grand Rounds meeting in April 27, 2020. The purpose of this study is to identity practice patterns among surgeons treating acute surgical diseases during the pandemic. Materials and methods: COVID-19 epidemiology, prevalence in surgical patients, and treatment options of patients with acute surgical diseases in the presence of SARS-CoV-2-positive status were discussed. An electronic audience response system was used to assess opinions and practice patterns of the participating surgeons. Deidentified data collection was performed, stored, and subsequently analyzed using Excel software 2018. Results: The conference was attended by 91 participants from 20 countries. Forty-six surgeons participated in the survey, with 36% practising at a hospital with >80 active COVID-19 inpatients. Forty-eight percent of the participating surgeons had provided surgical care for SARS-CoV2-positive (CoV+) patients. At the time of provider–patient interaction, 58% of surgeons were not aware of the CoV+ status. Surgeons reported changing practice patterns during the pandemic. They would treat CoV+ patients with acute cholecystitis with antibiotics only (64%), IR drain (12%), laparoscopic-(5%), open cholecystectomy (12%), and no opinion (7%). For acute appendicitis, 57% of surgeons favor antibiotics only vs open-(29%), laparoscopic appendicectomy (10%), and no opinion (4%). Gas/smoke-filtering systems for laparoscopy were available only to 14% of respondents. SARS-CoV-2 screening protocols utilize one RNA real-time polymerase chain reaction (RT-PCR) (29%), two RNA-RT-PCR 72 hours apart (7%), and IgG/IgM plus RNA RT-PCR (17%); 17% have no screening capacities. Conclusion: Standard acute-care surgery practice patterns changed favoring nonoperative treatment. Testing protocols vary among healthcare systems. Further studies are needed to understand the impact of the COVID-19 pandemic on outcomes in acute-care surgery patients.