Effects of the Covid-19 Pandemic on Patients with Fournier's Gangrene

Abstract

Background: The first case of COVID-19 infection in Turkey was reported on March 11th, 2020, and declared a pandemic by the World Health Organization (WHO) in March 2020, introducing new regulations to national health systems. Some patients with non-COVID-19 presentations may have been adversely affected by this pandemic. Objectives: The present study aimed to investigate the effect of COVID-19 on patients with Fournier's gangrene during the pandemic and the impact of the COVID-19 pandemic on the clinical management and patient outcomes for Fournier's gangrene. Methods: This retrospective cross-sectional study was conducted between March 2018 and March 2022 at the General Surgery Department of Trakya University. Patients were stratified into pre-pandemic and pandemic groups based on the date of March 11th, 2020, when the first Covid-19 case was reported in Turkey. Data collection and retrospective analysis were completed for all patients who were operated on for Fournier's gangrene originating from the perianal region. Demographic characteristics, predisposing factors, as well as laboratory and clinical results of the patients treated during the pandemic, were compared with the patients treated before the pandemic. Results: A total of 43 patients were included in the study (pre-pandemic: 24, pandemic: 19). There was a statistically significant difference between the pre-pandemic and pandemic groups in terms of the median length of hospital stay (7 vs. 16 days, p<0.001) and the median number of debridement (4 vs. 2, p=0.002). Conclusion: In the presence of life-threatening surgical pathologies, such as Fournier's gangrene, the number of admissions did not decrease despite the pandemic. Precautions taken to reduce the risk of transmission in pandemic conditions and more aggressive surgical applications can reduce the number of debridement procedures and shorten the length of hospital stay. Subsequently, this is associated with similar treatment outcomes, lower morbidity, and reduced treatment costs.