Emergency general surgical care during the COVID-19 pandemic presents a unique set of considerations and challenges. Patients presenting with acute surgical conditions and concomitant COVID-19 infection have higher risk of mortality and morbidity. The investigators present their experience with COVID-19 positive patients presenting with acute surgical conditions and reviewed the implementation of a protocolized pathway to mitigate the impact of COVID-19 infection.

All COVID-19 positive patients who presented to the acute general surgical service over a 2-month period were identified. Patient data including demographics, surgical diagnosis, mortality, morbidity and hospital length of stay was collected. Based on the investigators' early experience from the first patient, the investigators designed a protocolized institutional pathway which incorporated the risk of COVID-19 infection and urgency of operation.

Inclusion Criteria:

• All patients with emergency surgical conditions and tested positive for COVID-19 infection

Exclusion Criteria:

• Nil

A propsective review was performed of all patients with laboratory-confirmed COVID-19 infection who presented with acute general surgical conditions to Khoo Teck Puat Hospital (KTPH), in the period of 1st April 2020 to 31st May 2020. KTPH is a 795-bed regional general hospital in Singapore that serves approximately half a million people in the northern part of the city state. A confirmed case of COVID-19 was defined by a positive result on a reverse-transcriptase-polymerase-chain-reaction (RT-PCR) assay of a specimen collected on a nasopharyngeal swab. Patients underwent testing on admission if identified as high risk as per national guidelines, or upon developing respiratory symptoms during inpatient stay.

No plan to share individual participant data due to personal data protection act