Background In the midst of the COVID-19 pandemic, patients have continued to present with endocrine (surgical)
pathology in an environment depleted of resources. This study investigated how the pandemic affected endocrine
Methods PanSurg-PREDICT is an international, multicentre, prospective, observational cohort study of emergency
and elective surgical patients in secondary/tertiary care during the pandemic. PREDICT-Endocrine collected
endocrine-specific data alongside demographics, COVID-19 and outcome data from 11–3-2020 to 13–9-2020.
Results A total of 380 endocrine surgery patients (19 centres, 12 countries) were analysed (224 thyroidectomies, 116
parathyroidectomies, 40 adrenalectomies). Ninety-seven percent were elective, and 63% needed surgery within
4 weeks. Eight percent were initially deferred but had surgery during the pandemic; less than 1% percent was deferred
for more than 6 months. Decision-making was affected by capacity, COVID-19 status or the pandemic in 17%, 5% and
7% of cases. Indication was cancer/worrying lesion in 61% of thyroidectomies and 73% of adrenalectomies and calcium
2.80 mmol/l or greater in 50% of parathyroidectomies. COVID-19 status was unknown at presentation in 92% and
remained unknown before surgery in 30%. Two-thirds were asked to self-isolate before surgery. There was one COVID19-related ICU admission and no mortalities. Consultant-delivered care occurred in a majority (anaesthetist 96%,
primary surgeon 76%). Post-operative vocal cord check was reported in only 14% of neck endocrine operations. Both of
these observations are likely to reflect modification of practice due to the pandemic.
Conclusion The COVID-19 pandemic has affected endocrine surgical decision-making, case mix and personnel
delivering care. Significant variation was seen in COVID-19 risk mitigation measures. COVID-19-related complications were uncommon. This analysis demonstrates the safety of endocrine surgery during this pandemic.