Purpose
The coronavirus 2019 (COVID-19) pandemic resulted in major reorganization and limitations of clinical activities, changing the landscape for procedure-based specialties. We evaluated the change in case volume for interventional radiology (IR), gastroenterology (GI), and surgery (OR) during the lockdown period (LDP) for COVID-19 at a tertiary care hospital in New York State.
Materials and Methods
Retrospective analysis of the surgical procedures performed at a New York State tertiary care center during the LDP was performed. Comparison was made between LDP time period from March 15, 2020, to May 17, 2020 (LDP COVID), the 9-weeks immediately prior to LDP January 12, 2020, to March 15, 2020 (2020 pre-COVID), and the same time period in 2019 (2019 non-COVID), was performed. A univariable analysis was conducted for all IR procedures with specific attention paid to a subset of emergent procedures with overlap between the 3 specialties (percutaneous abscess drainage, gastrostomy, nephrostomy and cholecystectomy tube placement vs. percutaneous endoscopic gastrostomy (PEG), appendectomy, cholecystectomy, and cystoscopy stent placements). P values were calculated with a two-sample t-test. Statistical significance threshold was set at 5%. Statistical analysis was performed using Microsoft Excel.
Results
A total of 2105 IR procedures (LDP COVID: 551; 2020 pre-COVID: 721; 2019 non-COVID: 833) were included. During LDP COVID, case volume decreased by 23.6% (P < 0.023) and 33.9% (P < 0.117) when compared with 2020 pre-COVID and 2019 non-COVID, respectively, these were not statistically significant. Specifically examining the subgroup of emergent IR procedures, there was a 41.7% (188 vs. 322, P < 0.064) and 38.0% (188 vs. 303 P < 0.045) decrease from the LDP compared to 2020 pre-COVID and 2019 non-COVID time intervals, respectively.
For other procedural specialties, there was a 62.1% (113 vs. 298, P < 0.066) and 65.3% (113 vs. 326 P < 0.041) decrease in cases performed when compared to 2020 pre-COVID and 2019 non-COVID.
Conclusions
The census of our hospital during the height of the pandemic was over 40% COVID positive patients. This led to drastic changes to the schedule and workflow of patients. Volume in procedural specialties decreased as a result of the COVID pandemic. Non-IR specialties experienced a more prominent decrease in procedural volume during the LDP when compared to similar times before the pandemic. This is in stark contrast to IR, which did not see a statistically significant drop in the total amount of procedures performed due to the large volume of minimally invasive procedures performed in critically ill in-patients.