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Background Transmission of COVID-19 is a considerable risk during the perioperative period of emergency surgery. We aimed to provide a practical experienced adaptation to reorganize the emergency surgical pathways during the COVID-19 pandemic. Methods A prospective observational study was performed between 30th March 2020 to 30th June 2020 at a large DGH in England. The primary outcome was perioperative COVID-19 related complications and secondary outcome measures included incidence of COVID-19 infections among the surgical doctors and healthcare workers. Data was collected on the number of acute surgical admissions and operations performed. The perioperative COVID-19 status of the patients, doctors and the healthcare workers were recorded. Results 584 patients admitted through the emergency surgical pathway and 43% (n = 253) underwent surgical intervention. Approximately 5% (n = 30) patients contracted with COVID-19 during the perioperative period and 6 of them died. Eight surgical doctors, 11 nurses and theatre staff were confirmed for COVID-19 by swab test. Acute cholecystitis and early appendicitis were managed conservatively. Conclusion High mortality (20%) observed among the patients who contracted COVID-19 perioperatively. Acute surgical emergencies and perioperative management of the urgent surgical patients during the COVID-19 pandemic is a global challenge but adequate preparedness and strategic plan to adjust the surgical services can reduce the exposures to this highly contagious virus.

SP4.1.11 Acute general surgical emergency and COVID-19 is a pandemic challenge for surgeons: a UK based practical experience