నైరూప్య

Experience of COVID positive pediatric surgical patients from a tertiary care center in a Himalayan state.

Idrees Bashir, Raashid Hamid*, Akshit Sudhanshu, Tareq A Mir, Nisar A Bhat, Ajaz Ahmad Baba, Gowhar Nazir Mufti, Shoib Ahmad, Farhat Giri

Introduction: COVID-19 pandemic had a significant impact on the pediatric and neonatal surgery. The COVID-19 infection in children present either with mild symptoms or with atypical clinical features mimicking other infectious diseases. This study was conducted to assess the impact of COVID-19 pandemic and lockdown on the pediatric surgical cases admitted and managed at our Institute. Materials and Methods: Clinical characteristics and management & its outcome were noted down. Clinical characteristics included age, weight, gender, residence, nature of disease, any past history of surgery, history of contact with COVID patient, any recent COVID infection. These variables were compared with the patients managed during pre-COVID-19 era of same duration. All the babies admitted for routine and some emergency cases where tested for COVID-19 using RT-PCR method. COVID tests were done post-operatively in emergency cases. Results: During the study 630 patients were admitted and managed in our department, which included 200 elective, 150 semi emergencies, and 280 emergency cases. The average age was 19.53 ± 23 months. The study included 190 surgical neonates also. There were 400 male and 230 female patients. A total of 20 patients were tested positive during the study period. Among these 20 patients, 12 were tested positive on preoperative screening, while as eight cases were positive on post-operative COVID testing. Operation theatre days were reduced from 6 days to 4 days per week. The several measures undertaken in the outpatient clinic, operation theatre, pre and post-operative period to minimize the spread of COVID-19 virus from child to caregiver and surgical staff were highly effective. During these 9 months five doctors in our department got infected, with mild to moderate symptoms of COVID 19. They resumed their duties after an average of 2 to 3 weeks. Our academic activities got significantly hampered, although bedside teaching and case discussions continued in wards and operation theatres. Conclusion: COVID -19 pandemic effects pediatric population also, surgeries and the concern for its transmission. We continue to perform routine neonatal and pediatric surgical cases, while adapting the standard safety protocols. We believe that health professionals who use the appropriate personal protective equipment may continue to work in outpatient and operating rooms.