A Retrospective Analysis of the Trends in Acute Appendicitis During the COVID-19 Pandemic

Finkelstein, Paige; Picado, Omar; Muddasani, Kiranmayi; Wodnicki, Henry; Mesko, Thomas W.; Unger, S. W.; Bao, Philip; Jorge, Irving; Narayanan, Sumana; Ben-David, Kfır

doi:10.1089/lap.2020.0749

Cited by 53 publications

(71 citation statements)

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“…Surgical procedures were limited only for the care of urgent surgical or trauma patients. These efforts to minimize unnecessary traffic through the healthcare facility resulted in a significant reduction in emergency department patient encounters [ 12 , 13 ]. Significant increases in delayed care for different medical emergencies, including pediatric surgical emergencies, during the COVID-19 pandemic period has been noted by the medical community and published in several reports [ 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies of acute appendicitis during COVID-19 pandemic clearly showed that staying at home due to public health safety orders negatively impacted children who developed appendicitis. During the COVID-19 pandemic increased rate of perforated appendicitis in pediatric patients, compared to pre-COVID-19 period, was reported in several published studies [ 11 , 13 , 14 , 15 ]. Also, the patients with perforated appendicitis had an increased rate of complications and length of hospital stay [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Is there an increased incidence of orchiectomy in pediatric patients with acute testicular torsion during COVID-19 pandemic?–A retrospective multicenter study

Pogorelić

Milanović

Veršić

et al. 2021

Journal of Pediatric Urology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is there an increased incidence of orchiectomy in pediatric patients with acute testicular torsion during COVID-19 pandemic?–A retrospective multicenter study

Pogorelić

Milanović

Veršić

et al. 2021

Journal of Pediatric Urology

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“…This systematic review included 14 studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] published in 2020. Five studies were based in the UK, three in USA, two in China, and one in Ireland, Nepal, Israel, and India.…”

Section: Study and Patients' Characteristicsmentioning

confidence: 99%

Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis

Emile

Hamid²,

Khan

et al. 2021

Journal of Gastrointestinal Surgery

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Background Non-operative management (NOM) of acute appendicitis has been assessed in several studies before COVID-19 pandemic. This systematic review aimed to assess the extent of adoption, efficacy, and safety of NOM of acute appendicitis in the setting of COVID-19. Methods This was a PRISMA-compliant systematic review of the literature. Electronic databases and Google Scholar were queried for studies that applied NOM of acute appendicitis during COVID-19. The main outcome measures were the rates of NOM application during the pandemic as compared to the pre-pandemic period, failure and complication rates of NOM. Failure was defined as the need for appendectomy during NOM and complications included development of appendicular mass or abscess. Results Fourteen studies (2140 patients) were included. The male to female ratio was 1.44:1 and median age was 34. Nine hundred fifty-nine (44.8%) patients had a trial of NOM. The weighted mean rate of NOM application was 50.1% (95%CI: 29.8–70.5%). The application of NOM during the pandemic was significantly more likely than its application before COVID-19 (OR = 6.7, p < 0.001). The weight mean failure rate of NOM was 16.4% (95%CI: 9.4–23.4). NOM failure was more likely in children and patients with complicated appendicitis. The weighted mean complication rate after NOM was 4.5% (95%CI: 1.4–7.7). NOM had significantly lower odds for complications than appendectomy (OR = 0.36, p = 0.03). There was no mortality after application of NOM. Conclusion NOM of acute appendicitis in the setting of COVID-19 may be a safe, short-term alternative to surgery with acceptably low failure and complication rates. Supplementary Information The online version contains supplementary material available at 10.1007/s11605-021-04988-1.

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“…The CRAC study showed that in a selected cohort of Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped and that during the rst wave of the COVID-19 pandemic, patients undergoing surgery were more frequently affected by more severe forms of appendicitis compared to the same timeframe of the previous year. This is the outcome of data analysis of over 1,300 individual patients undergoing appendectomy for acute appendicitis, a much more comprehensive dataset than previous international and national surveys [8,19,20] and multicenter retrospective studies [21,22] had suggested or highlighted.…”

Section: Discussionmentioning

confidence: 99%

Appendectomy During the COVID-19 Pandemic in Italy. A Multicenter Ambispective Cohort Study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study).

Sartori

Podda

Botteri

et al. 2021

Preprint

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Background To determine on a national basis the surgical activity regarding appendectomies during the first Italian wave of the COVID-19 pandemic. Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. Methods Multicenter, observational study investigating the outcomes of patients undergoing appendectomy in the two months of March-April 2019 vs. March-April 2020. The primary outcome was the number of appendectomies performed during each of the two months, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs. open), and the complication rates. Results 1541 patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the study inclusion criteria. 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.8%) in 2019. Patients with complicated appendicitis operated in 2019 were 76 (9.6%) vs. 87 (15.9%) in 2020 (p = 0.001). An increase in the number of post-operative complications was found in 2020 (15.9%) compared to 2019 (9.6%) (p < 0.001). The following determinants increased the likelihood of complication occurrence: undergoing surgery during 2020 (+ 67%), having a unit AAST (+ 26%) increase, having waited for surgery > 24 h (+ 58%), being the surgeon aged > 40 years (+ 47%), undergoing open surgery (+ 112%) and being converted to open surgery (+ 166%). Conclusions In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. Patients undergoing surgery during the first pandemic wave were more frequently affected by more severe appendicitis than the previous year's timeframe and a higher complication rate was reported. Trial registration: ResearchRegistry ID 5789.

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A Retrospective Analysis of the Trends in Acute Appendicitis During the COVID-19 Pandemic

Cited by 53 publications

References 2 publications

Is there an increased incidence of orchiectomy in pediatric patients with acute testicular torsion during COVID-19 pandemic?–A retrospective multicenter study

Is there an increased incidence of orchiectomy in pediatric patients with acute testicular torsion during COVID-19 pandemic?–A retrospective multicenter study

Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis

Appendectomy During the COVID-19 Pandemic in Italy. A Multicenter Ambispective Cohort Study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study).

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