Purpose
Several studies have reported venous thromboembolism after COVID-19. This association raises the possibility that the incidence of ischemic enterocolitis (IE) may have increased during the COVID-19 pandemic. This study aimed to identify changes in the incidence of IE using the National Health Insurance Service (NHIS) database in Korea and to assess the clinical impact of COVID-19.
Methods
Using the NHIS data from 2016 to 2022, we identified 2,637 patients who underwent surgery after a diagnosis of IE. The primary endpoint was the annual incidence of IE and whether this incidence changed during the COVID-19 period.
Results
The incidence per million population was calculated using the total population of Korea as the denominator. The annual incidences of IE from 2016 to 2022 were 6.56, 6.76, 6.98, 7.73, 7.35, 8.08, and 7.65 per million population, respectively. Poisson regression showed an annual increase in IE incidence (incidence rate ratio [IRR], 1.044; 95% confidence interval [CI], 1.004–1.085; P=0.029), whereas the COVID-19 period was not associated with a significant change in IE incidence (IRR, 0.945; 95% CI, 0.811–1.103; P=0.475).
Conclusion
The incidence of IE increased significantly over time, but no significant increase was observed during the COVID-19 period.

Purpose
Acute appendicitis is the most common abdominal surgical emergency worldwide, but hospital-based surgical case volume and disease severity continue to vary over time. Regional differences, the COVID-19 pandemic, and changes in surgical management indicate the need for updated local data.
Methods
We conducted a retrospective study of all patients who underwent appendectomy for acute appendicitis at Nhan dan Gia Dinh Hospital, a tertiary referral hospital in Ho Chi Minh City, Vietnam, between January 2019 and July 2025. Data were extracted from electronic medical records and included demographic characteristics, disease severity, operative approach, and operative time. Temporal patterns were analyzed by year, month, and time of day.
Results
A total of 7,768 patients were included. Uncomplicated appendicitis accounted for most cases, and patients with complicated appendicitis were older than those with uncomplicated disease. Female patients constituted a slight majority. Overall case numbers declined markedly in 2021, coinciding with the peak of the COVID-19 pandemic, and then stabilized. Seasonal variation was observed. Laparoscopy was the predominant operative approach, accounting for 99% of cases. The mean operative time was 75 minutes. Nighttime operations were associated with slightly longer operative times overall than daytime operations (77 minutes vs. 74 minutes), including among patients with peritonitis.
Conclusion
Over 7 years, hospital-based surgical case volume for acute appendicitis declined, whereas the proportion of complicated cases remained stable. Temporal fluctuations indicate dynamic changes in case numbers. Laparoscopy remained the predominant approach, reflecting sustained use of minimally invasive surgery.

Purpose
The COVID-19 pandemic significantly disrupted surgical services and necessitated the development of new clinical protocols. National Health Insurance Service Ilsan Hospital in Korea established a COVID-19 Emergency Surgical Team (CEST) to manage surgical cases and optimize medical staff utilization, thereby ensuring timely care during the pandemic. This study describes our experience with the CEST and highlights its potential role in institutional preparedness for future public health crises.
Methods
Between December 19, 2020, and April 4, 2022, this study included patients with laboratory-confirmed COVID-19 who were hospitalized at National Health Insurance Service Ilsan Hospital, a designated COVID-19 treatment center in Korea. Among these patients, those who underwent abdominopelvic computed tomography (APCT) were selected for analysis, and the indications for APCT were categorized. Patients specifically evaluated for suspected surgical abdomen were identified for subgroup analysis.
Results
Among 90 patients who underwent APCT, 32 (36.0%) were evaluated for suspected acute abdomen requiring urgent attention; 25 (28.1%) for persistent fever or elevated inflammatory markers; 15 (16.9%) for acute kidney injury; and 7 (7.9%) for liver enzyme elevation. Compared with the remaining 3,765 patients, the 32 patients with suspected surgical abdomen were significantly older and had longer hospital stays, higher rates of intensive care unit admission, and greater use of high-flow nasal cannula, dexamethasone, and antibiotics. Initial laboratory findings demonstrated higher white blood cell count, ferritin, creatinine, bilirubin, and D-dimer levels in this group. This case series underscores the role of the CEST in managing surgical patients with COVID-19.
Conclusion
We describe our institutional experience with the CEST and emphasize how the lessons learned may inform preparedness for future public health emergencies. This model may serve as a practical framework for managing surgical care during similar crises.

Trauma surgeons' roles in a national hospital in Korea changed during the COVID-19 pandemic. In this study, we report on their roles over a 15-month period (March 2020 to May 2021) including the eight months where the hospital was a COVID-19-only hospital. Despite shortages in medical resources including medical personnel, and intensive care unit (ICU) beds, the trauma surgeons helped to control the public health problem by assuming various roles including working in another COVID-19 ICU in Dae-gu, treating trauma patients with COVID-19 or those who needed self-quarantine, being in charge of care for some COVID-19 patients in the ICU (for two months), and performing the role of a rapid response team member for COVID-19 ICU patients. In this report, we emphasize how trauma surgeons, along with intensivists, played an active role in treatment of COVID-19 patients, and helped prevent the collapse of the healthcare system within the hospital during the pandemic.

Citations

• Computed tomography-based triage and outcomes of a dedicated COVID-19 Emergency Surgical Team (CEST) for suspected acute abdomen in a Korean COVID-19 base hospital: a retrospective cohort study
  Jun Hyung Kim, Sungho Lee, Kwanhoon Park, Kang Yoon Lee, Da Hyun Jung, Il Jo, Hangil Yun, Ji Young Jang
  Journal of Acute Care Surgery.2026; 16(1): 31.     CrossRef

Purpose
Patients with coronavirus disease 2019 (COVID-19) should be isolated from others to prevent widespread infection. The purpose of this study was to evaluate the feasibility of performing peripherally inserted central catheter (PICC) placement in patients with COVID-19 isolated in the intensive care unit (ICU) of a small volume center hospital.
Methods
This retrospective study included 79 patients who underwent PICC in 2 ICUs. There were 41 patients with COVID-19 who were isolated in an ICU (isolated ICU) and there were 38 patients who required ICU care who did not have COVID-19 (non-isolated ICU). Their medical records including PICC-related complications and clinical variables were compared.
Results
PICC placement was performed to maintain long-term intravenous access for 78% of the COVID-19 group and 52.6% of the non-COVID-19 group (p = 0.017). The mean procedure time (minutes) was 15.2 ± 7.58 in the COVID-19 group and 12.6 ± 6.65 in the non-COVID-19 group (p = 0.109). When PICC tip locations were divided into three groups (optimal, suboptimal, and malpositioned), there was no significant difference between the two groups of patients. PICC-related complications in COVID-19 and non-COVID-19 groups included non-functioning catheter (0% vs. 5.3%, p = 0.137), occurrence of swelling or hematoma around PICC inserted site (2.4% vs. 0%, p = 0.333), and PICC-related infection.
Conclusion
PICC placement for patients with COVID-19 isolated in the ICU of a small volume center hospital was feasible and safe.

Citations

• Outcomes of a bedside ultrasound-guided peripherally-inserted central catheter placement across critically-ill older patients
  Kyungwon Lee, Kyoung Won Yoon, Minchang Kang, Donghyoun Lee, Kiyan Heybati
  PLOS One.2026; 21(3): e0336966.     CrossRef
• Analysis of Risk Factors for Peripherally Inserted Central Venous Catheter-Associated Bloodstream Infection
  Sungho Lee, Kwanhoon Park, Kang Yoon Lee, Dongbeen Choi, Ji Young Jang
  Journal of Acute Care Surgery.2024; 14(1): 9.     CrossRef

In August, 2011, the Korean Public Health Surveillance declared an outbreak of pulmonary disease due to the inhalation of humidifier disinfectants (HDs), which led to approximately 20,000 deaths. In March, 2020, the World Health Organization declared coronavirus disease-2019 (COVID-19) a pandemic. In this Case Report, we present a rare case of a patient who inhaled toxic HDs and developed COVID-19. He was young and had a low risk of severe COVID-19, however, he had a critical course to recovery. He was admitted to the intensive care unit and administered high-flow oxygen via a nasal cannula. He received dexamethasone injections each day for 10 days and his condition began to improve on hospital Day 6, although radiographical findings revealed no improvement. He was discharged on hospital Day 26. Despite the patient’s chronic lung disease becoming asymptomatic, HDs could be an important risk factor affecting the clinical course of COVID-19.

Extracorporeal membrane oxygenation (ECMO) may be required in patients with corona virus disease-19 (COVID-19) and respiratory failure. Anticoagulation is the standard treatment to prevent complications of ECMO and COVID-19 coagulopathy, however, there is a risk of bleeding. Some patients with retroperitoneal hemorrhage (RPH) have been treated with angiography-embolization. We report on a patient with COVID-19 on ECMO who underwent multiple operations (×5) for recurrent RPH. A 46-year-old man was admitted with COVID-19 pneumonia. ECMO with anticoagulation therapy was initiated. The patient developed RPH, caused by external compression of the inferior vena cava interrupting the ECMO inflow, and surgical hematoma evacuation was performed, with no obvious bleeding focus during the multiple surgeries. Following the patient’s recovery, a follow-up computed tomography scan showed the hematoma had been resolved, but there was a dilemma regarding anticoagulation. Lowering the threshold for surgical treatment, enabled treatment of a patient with serious RPH.

When a patient with severe trauma is admitted to the emergency room (ER), they are evaluated before transfer to either the intensive care unit (ICU) or operating room. To minimize the time until a definitive treatment can be provided, direct operating room resuscitation can be performed. In this hospital the ER was closed during the hospital’s transition to a coronavirus disease 2019-dedicated hospital, and direct ICU resuscitation for patients with trauma was performed for a short period. To perform effective trauma resuscitation, all ICU beds were reorganized to achieve a modified, experienced nurse: patient ratio (1:2-3) and 2 beds were assigned for trauma ICU resuscitation alone. The equipment for initial resuscitation was installed and ICU nurses received training. Consultations with the hospital administration, nursing, and pharmaceutical departments were completed in advance to avoid formal problems. Conversion of the ICU for direct resuscitation procedures was performed in 4 patients.

Purpose
The coronavirus disease 2019 (COVID-19) pandemic continues. It has been reported that patients with bacterial coinfection have a higher mortality rate than patients without coinfection. However, there are no clear standard guidelines for the use of antibacterial drugs. Therefore, the purpose of this study was to determine the usefulness of procalcitonin, a specific indicator of bacterial infection, as a biomarker for predicting death in COVID-19 patients.
Methods
This was a retrospective study of confirmed COVID-19 patients (N = 283) between December 2020 and February 2021 who survived or died. Logistic regression analysis was performed to determine whether there was an association between the level of procalcitonin and death. In addition, receiver operating characteristic curve analysis was performed to determine the usefulness of procalcitonin as a predictor of death.
Results
In the non-survivor group, age, the number of patients transferred from a health care center, segment neutrophil ratio, C reactive protein, ferritin, and procalcitonin were significantly higher in the survivor group. In multivariate analysis, procalcitonin was identified as an independent factor associated with death (hazard ratio 6.162, confidential interval 2.285-26.322, p = 0.014). In addition, the predictive power of procalcitonin level and mortality was statistically significant using receiver operating characteristic curve analysis which gave an area under the curve value of 0.823, a cut-off value of 0.05, a sensitivity of 72.2%, a specificity of 87.5% (p < 0.001).
Conclusion
Measurement of procalcitonin and other biomarkers may be useful to determine whether to use or discontinue use of antibacterial drugs in patients with COVID-19.

Citations

• Computed tomography-based triage and outcomes of a dedicated COVID-19 Emergency Surgical Team (CEST) for suspected acute abdomen in a Korean COVID-19 base hospital: a retrospective cohort study
  Jun Hyung Kim, Sungho Lee, Kwanhoon Park, Kang Yoon Lee, Da Hyun Jung, Il Jo, Hangil Yun, Ji Young Jang
  Journal of Acute Care Surgery.2026; 16(1): 31.     CrossRef
• Role of Inflammatory Markers in Severity, ICU Admission, and Mortality in COVID-19: A Systematic Review and Meta-analysis of 79,934 Patients
  Hiwa O. Abdullah, Sadraldin A. Braim, Maria A. Rasool, Dashne M. Abdalla, Dyari Q. Hamad, Daban K. Ahmad, Ayman M. Mustafa, Fakher Abdullah, Yousif M. Mahmood, Dilan S. Hiwa, Sasan M. Ahmed, Karokh K. Mohammed, Berun A. Abdalla, Shvan H. Moh
  Barw Medical Journal.2024;[Epub]     CrossRef