Impact of hospital lockdown secondary to COVID-19 and past pandemics on surgical practice: A living rapid systematic review

Am J Surg. 2021 Jul;222(1):67-85. doi: 10.1016/j.amjsurg.2020.11.019. Epub 2020 Nov 12.

Abstract

Background: The COVID-19 pandemic has disrupted surgical practice worldwide. There is widespread concern for surgeon and provider safety, and the implications of hospital lockdown on patient care during epidemics.

Methods: Medline, EMBASE, CENTRAL, and PubMed were systematically searched from database inception to July 1, 2020 and ongoing monthly surveillance will be conducted. We included studies that assessed postoperative patient outcomes or protection measures for surgical personnel during epidemics.

Results: We included 61 studies relevant to the COVID-19 pandemic and past epidemics. Lockdown measures were noted globally including cancellation of elective surgeries and outpatient clinics. The pooled postoperative complication rate during epidemics was 21.0% among 2095 surgeries. 31 studies followed the health of surgical workers with the majority noting no adverse outcomes with proper safety measures.

Conclusions: This review highlights postoperative patient outcomes during worldwide epidemics including the COVID-19 pandemic and identifies specific safety measures to minimize infection of healthcare workers.

Keywords: COVID-19; Epidemic; Health care worker; Lockdown; Surgical outcomes.

Publication types

  • Systematic Review

MeSH terms

  • Ambulatory Care / organization & administration
  • COVID-19 / epidemiology*
  • Clinical Protocols
  • Elective Surgical Procedures / statistics & numerical data
  • Hospital Administration*
  • Humans
  • Infection Control / methods*
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Medical Staff, Hospital
  • Pandemics*
  • Personal Protective Equipment
  • Postoperative Complications / epidemiology
  • SARS-CoV-2
  • Surgical Procedures, Operative / statistics & numerical data