الفهرس 
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Abstract
”Outcome of Emergency Abdominal Surgical Operations During COVID-19 Pandemic in a High-Volume Centre: Retrospective Comparative Cohort Study. Objective: This retrospective comparative cohort study aimed to investigate the outcomes of emergency abdominal surgical operations before and during the COVID-19 pandemic. Methods: The study included two groups of patients: group 1, consisting of patients admitted between April 2019 and March 2020 (pre-pandemic), and group 2, consisting of patients admitted between April 2020 and April 2021 (during the pandemic). Various demographic, clinical, and laboratory variables were collected and compared between the two groups. Results: The mean age of patients in group 1 was 51.49 years (SD 18.54), while in group 2, it was 50.01 years (SD 17.93), showing no statistically significant difference (p=0.3288). Similarly, the comparison of BMI between the two groups (group 1: mean BMI 27.97 kg/m², SD 6.33; group 2: mean BMI 28.57 kg/m², SD 6.2) did not reveal a significant difference (p=0.2534). Diagnoses: No statistically significant differences were observed in the distribution of diagnoses between group 1 and group 2, except for diverticulitis, which was more prevalent in group 2. Preoperative COVID-19 symptoms: Fever, cough, shortness of breath, abdominal pain, expectoration, and diarrhea were significantly more prevalent in group 2 compared to group 1. Nausea and vomiting did not show a statistically significant difference between the two groups. Preoperative ventilation: The use of preoperative ventilation methods such as room air, CPAP, and mask was significantly higher in group 2 compared to group 1. COVID-19 test status: group 2 had a significantly higher proportion of individuals testing positive for COVID-19 compared to group 1. group 1 had no positive cases. Tests specific for COVID-19: CT scan of chest, chest x-ray, RT PCR, and antigen and antibody tests showed significant differences in distribution between the two groups, with group 2 having higher frequencies of positive results. Type of operation: Laparoscopic operations were more common in group 2, while open operations were more common in group 1. CBC: Hemoglobin (HGB) levels were significantly lower in group 2 compared to group 1. There were no statistically significant differences in white blood cell count or platelet count. Liver function tests: Alanine aminotransferase, aspartate aminotransferase, blood albumin, and alkaline phosphatase levels were significantly higher in group 2 compared to group 1. Total bilirubin levels did not show a statistically significant difference. Inflammatory markers: CRP and D-dimer levels were significantly higher in group 2 compared to group 1. PCT levels did not show a statistically significant difference. Clinical outcomes: group 2 had a higher proportion of deaths, postoperative complications, refusal to accept hospitalization or treatment, and positive COVID status after 30 days of admission compared to group 1. No significant differences were observed in the proportion of cured/improved and discharged individuals or readmission between the two groups. Conclusion: The study found no statistically significant differences in age and BMI between patients undergoing emergency abdominal surgical operations before and during the COVID-19 pandemic. However, there were significant differences in the distribution of comorbidities, preoperative symptoms, and ventilation methods between the groups. group 2 (during the pandemic) had a higher prevalence of fever, cough, shortness of breath, and other COVID-19 related symptoms. Preoperative ventilation, especially with CPAP and masks, was more frequently required in group 2. COVID-19 testing showed that none in group 1 tested positive, while a significant proportion in group 2 did. This was reflected in the significant differences observed in the results of CT scans, chest x-rays, RT-PCR, and antigen tests, highlighting the importance of accurate testing during the pandemic. Surgical methods also differed, with laparoscopic surgeries being more common in group 2, while open surgeries were more prevalent in group 1. There were significant differences in CBC parameters and liver function tests, with group 2 showing lower hemoglobin levels and higher inflammatory markers such as CRP and D-dimer. Despite no significant differences in the distribution of specific morbidities, group 2 exhibited higher rates of mortality, postoperative complications, refusal of hospitalization or treatment, and positive COVID-19 status after 30 days. The higher death rate in group 2 was statistically significant, underscoring the impact of the pandemic on surgical outcomes. Further research is warranted to explore other variables and factors influencing these outcomes during the pandemic.