Effect of the Covid-19 pandemic on clinical outcomes of surgical patients with gastrointestinal cancers

Introduction: In December 2019, the SARS-CoV-2 virus and the disease it caused called COVID-19 were identified in China, generating a global pandemic. The severity of the pandemic and the exhaustion of health services required the prioritization of urgent and emergency surgeries and the suspension of elective surgeries, minimizing the spread of COVID-19. Interrupting cancer surgeries poses a potential risk to patients and studies remain scarce.

Objective: To analyze the impact of the COVID-19 pandemic on surgical patients with gastrointestinal cancer treated by the Unified Health System SUS in a Tertiary Hospital in the South of Brazil in the year 2020 (COVID-19 Pandemic) compared to the year 2019 (pre pandemic). Materials and methods: Cohort study that evaluated adult patients with gastrointestinal tumors who underwent surgery between the pre-pandemic and pandemic periods.

Results: 372 patients with gastrointestinal cancer who underwent surgery were included, of which (54%) during the pandemic and (46%) pre-pandemic. There was a 14% increase in emergency surgeries (P = 0.001); 11% reduction in the need for an intensive care unit (p = 0.034) and a 7-day reduction in hospital stay (p = 0.003) during the pandemic, with no impact on 30-day mortality, general mortality or advanced cancer. SARS-CoV-2 infection had a rate of 11.9%, these had a higher overall mortality rate (8 [33%] positive vs 8 [8%] negative, P = 0.003), 30-day mortality (6 [25%] %] positive vs 5 [5.2%] negative, P = 0.008), and length of stay (mean 57.38 ± 69.47 days for positive vs 30.24 ± 23.91 for negative, P = 0.008).

Conclusions: There was no significant impact of the pandemic on overall and 30-day mortality or on the incidence of advanced cancer. We suggest not suspending oncological surgeries during pandemics.

Corresponding author: Gabriel Ben Bordinhão (e-mail: gabriel.bordinhao@ufcspa.edu.br).