Comportamiento de la urgencia ginecológica durante la pandemia de COVID-19

Abstract

Introduction: The COVID-19 pandemic has meant a decrease in gynecological visits to the emergency department. Objective: To characterize the attending in the gynecological emergency service, evaluating the amount of admissions, hospitalizations, need for surgical intervention, morbidity factors, among others, compared to the pre-pandemic situation. Method: A non-concurrent cohort study of hospitalized patients was carried out through a spontaneous attending to the gynecological emergency service between weeks 12 and 28 of 2019 and 2020 at the Hospital Clínico of the Pontificia Universidad Católica, in Santiago (Chile). Different morbidity factors were measured: admission diagnosis, surgical intervention, surgical complication, hospital stay, admission hemoglobin, and need for transfusion of blood units. Results: A total of 511 visitors to the emergency service were registered between weeks 12 and 28 of 2019, compared to 196 in 2020. In 2019 and 2020, 103 and 72 women were hospitalized respectively (odds ratio [OR]: 2.3). Admission for pregnancy loss decreased (24 vs. 12; p = 0.01), while admission for postmenopausal bleeding increased (9 vs. 22; p = 0.01). There was no change in the surgical interventions performed (86.4% vs. 84.7%; p = 0.7). The hospital stays increased (2.3 vs. 3.1; p < 0.0001) and the need for blood transfusion (2 vs. 7; p = 0.02; OR: 5.4; confidence interval: 1.09-26). Conclusions: The COVID-19 pandemic caused a decrease in spontaneous attending for gynecological pathology at the emergency service, causing an increase in the attend/admission ratio and greater morbidity in hospitalized patients characterized by a greater need for blood transfusion and an increase on the hospital stay.