• R Patel, A J Hainsworth, K Devlin, J H Patel, and A Karim.
• Department of Colorectal Surgery, St. George's Hospital, London, UK.
• Ann R Coll Surg Engl. 2020 Jun 27: 1-6.

IntroductionThe COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown.Materials And MethodsThis study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown.ResultsA total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, p = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, p = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, p = 0.04).ConclusionFewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.

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