Pacientes con falla intestinal atendidos en tiempo de la pandemia por COVID-19 en la Unidad de Falla Intestinal

Abstract

At the end of 2019, the first cases of SARS-CoV-2 infection were reported in China and in March 2020 the pandemic was declared. When it arrived in Peru, the government declared a national state of emergency, which impacted on the daily development of Peruvian society and transformed the hospital management of patients, including those diagnosed with intestinal failure. A series of preventive and restrictive measures were established that limited the processes to be followed in the treatment of patients. These measures were established when the Intestinal Failure Unit of the Guillermo Almenara Irigoyen National Hospital had hospitalized patients. There are no studies on the evolution of patients with intestinal failure during this pandemic and we lack theoretical support; Furthermore, the immunosuppression condition per se of the patient with intestinal failure and references made by some studies that relate inflammatory bowel disease and COVID-19 do not allow us to draw some conclusions. Data was collected in a file and a database was made in Excel. The study began on March 16 and closed on June 17; 4 patients were admitted, 3 men and 1 woman with an average age of 49.8 years, the mean time of hospitalization before CRATGI was 5.5 days and the mean time from the last surgery to the CRATGI was 161.5 days (5.3 months), the mean operative time for CRATGI operative mean was 247.5 minutes and the mean postoperative hospitalization time was 41.3 days (patient 4 is still hospitalized). The 4 patients underwent CRATGI. In the postoperative period, 2 patients were diagnosed with SARS-CoV2 and went to the COVID area; one of them died of SARS. Postoperative complications were: a catheter-related infection, a wall hematoma and 2 cases of prolonged ileus. Mortality was 25%. Coordination meetings by members of the intestinal failure unit were held once a week by videoconference. This series of cases is the first report we make of the management of our patients with intestinal failure during the pandemic in which we observed a 25% mortality due to SARS-CoV-2; it also allows us to conclude that the follow-up and discussion of cases can continue through virtual platforms.