Impact of the COVID-19 Pandemic on Elective and Emergency Pediatric Surgeries: A Single-Center Experience in a Tertiary Center in Iran

Background: The COVID-19 pandemic has disrupted healthcare systems globally, leading to the suspension of many elective surgeries. The impact of the pandemic on pediatric surgical care in tertiary centers is not well understood. This retrospective study aims to examine the effect of COVID-19 on the management of surgical diseases in children. Methods: A retrospective single-center cross-sectional study was performed to collect information on the children who were operated either emergently or in an elective setting. The demographics, field of surgery, outcomes, and the rates of mortality and morbidity were measured. Moreover, this study evaluated the associations between coronavirus disease 2019 (COVID-19) infection and surgical outcomes and length of hospital stay. Results: A total of 1028 children were included in the study with an average age of 60.51 ± 50.3 months. Only 33 children (3.2%) were positive for COVID-19 during the admission days. Moreover, 87 (8.5%) patients developed pulmonary, gastrointestinal, or infectious complications, and 22 patients (2.5%) expired. Morbidity was significantly associated with the presence of COVID-19 infection (p 0.001). Furthermore, the rate of complications was much higher in patients who underwent emergency operations (p 0.001). In addition, mortality in positive cases was remarkably higher than that in negative cases (22.2% vs. 1.9%, p 0.001). Conclusion: The overall rates of complications, morbidity, and mortality were much higher in emergency operations compared to elective surgeries. Also, the presence of COVID-19 infection in this population led to more cases of morbidity.