European Journal of Biomedical and Pharmaceutical Sciences

STUDY ON THE IMPACT OF COVID -19 ON PEPTIC ULCER PERFORATION

J. A. Jayalal*, Poornachandran, Pachai Pandi, Sathik, Deepan Karthick, Vignesh, Balraj and Rajesh

ABSTRACT

Introduction: SARS COV2 disease has emerged as a global health threat with a great number of deaths in the world accounting to nearly 1 million. The World Health Organisation on the 11th March 2020 declared the novel disease COVID-19 caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) as a pandemic .This COVID-19 pandemic has created a significant changes in the approach of patients for elective surgery for their presenting surgical diseases. Due to various physical, economic and social reasons they are not able to report early even when the red flag signs are raised, resulting in undue complications. leading on to increased morbidity and mortality. Peptic ulcer perforation is a common cause of emergency admission and surgery. Most peptic ulcers are caused by H. pylori or NSAIDs and changes in epidemiology mirror changes in these principal etiological factors. Duodenal ulcers are more common than gastric ulcers, but the symptoms are indistinguishable. In this study we tried to find out the impact COVID-19 has had on peptic ulcer disease presenting with perforation and perforation peritonitis. Methodology: The study was carried out from March 2020 when government announced public lockdown till September 2020 in Tirunelveli Medical College Hospital and all patients admitted in emergency room with perforation and taken up for emergent surgery were included. For comparison, patients admitted with DU perforation and operated during the preceding 6 months from September 2019 to February 2020 were retrospectively analysed. Observation: Majority of the perforation was from duodenal ulcer and the emergence of COVID has had a direct impact on peptic ulcer disease presenting as perforations. Comparing with the corresponding 6 months prior to the COVID pandemic, with the current period of study during COVID-19 pandemic, there is 25% increase in the reported cases of perforation. Two direct reasons for the above said scenario are people opting to over the counter NSAIDS for mild vague abdominal pain as they could not reach the hospitals owing to lockdown. The second one seems to be due to increased alcohol intake and sedentary life style adopted by the people. Conclusion: People from remote places ignore vague abdominal pain and find temporary relief with OTC NSAIDs. This COVID-19 has made the scenario worse by public lockdown and alcohol abuse. Thus peptic ulcer disease has presenting with complicated perforations warranting emergency surgery. Thus COVID has had a negative impact on peptic ulcer disease.

Keywords: COVID-19 Pandemic, peptic ulcer, perforation, stress.