Acute appendicitis management during the COVID-19 pandemic: A prospective cohort study from a large UK centre

Management of Acute Appendicitis in Children During COVID-19 and Perspectives of Pediatric Surgeons From South Asia: Survey Study

“…In an Indian study, Verma et al [ 26 ] documented how their institute increased their percentage of NOT to 69% of patients, a significant increase from 22% recorded during the same time period in 2019. The recent work of Ielpo et al [ 27 ] also showed an increased usage of NOT in pediatric appendicitis during the pandemic, as did a study from the United Kingdom [ 28 ]. More recently, the usage of NOT and the resulting outcomes of AUA in the setting of COVID-19 was systematically reviewed.…”

The effect of the Covid-19 outbreak on the management of acute appendicitis: A retrospective comparative cohort study

“…CT was the most common imaging method used for AA with 54.05% during the pre-pandemic, and 69.64% during the pandemic periods; however, USG was used in 10.8% before the pandemic, in 12.5% during the pandemic. Antakia et al [16] reported a significant decrease in USG use (16.5% vs 24.1%); however, a significant increase was observed in CT use (87.5% vs 69.8%) during the pandemic for AA imaging. The diameter of the appendix being ≥ 7mm was a sign of AA.…”

“…Lower length of hospital stay is desired and favored during the pandemic to decrease the contamination of Cov19 and to empty the beds for a new outbreak. Some studies reported no differences in LOS between these periods [16][17]; however, Kvasnovsky et al [18] reported a significantly higher LOS for AA during the pandemic. Conservatively treated AA patients had longer LOS than the operated patients in both periods [14,19].…”

“…The management algorithms of emergency disease have changed during Cov19 [28,29]. The management of acute appendicitis involves, if possible, conservative treatment as an outpatient, short hospitalization, operation with an open technique and under regional anesthesia [16]. AA was managed conservatively in 5.4-22.2% of the patients during the prepandemic period, which increased to 7.8-100% during the pandemic [30].…”

A commentary on “Changes in appendicitis treatment during the COVID-19 pandemic - A systematic review and meta-analysis” (Int J Surg 2021;95:106,148)

“…Although surgical intervention is still regarded as the gold standard for acute appendicitis (AA) management, a conservative non-operative approach in selected patients through administration of intravenous antibiotics as a first-line treatment has been well described. A meta-analysis published in 2019 summarized the results of twenty studies, including seven prospective randomized controlled trials, four retrospective cohort studies, one quasi-randomized study, and eight prospective cohort studies [ 2 ]. Antakia et al demonstrated an association of antibiotic treatment with a significantly lower post-surgical complication rate ( e.g.…”