Author response to: Comment on: Patterns of acute surgical inflammatory processes presentation of in the COVID-19 outbreak (PIACO Study): surgery may be the best treatment option

Guadalajara, Héctor; Nova, José Luis Muñoz de; Gonzalez, Saul Fernandez; Yiasemidou, Marina; Rico, M; Juez, Luz Divina; Septiem, Javier García; Jara, P Galindo; Virosta, Mariana García; Martínez, Eduardo Lobo; Martín-Pérez, Elena; García-Olmo, Damián; Fernández-Cebrián, J M; Martin, Alexander; Jover, J. M.; Iparraguirre, M. A.; Acín-Gándara, Débora; Perea-del-Pozo, E; Dios‐Barbeito, Sandra; Martín-Antona, Esteban; Durán-Poveda, Manuel; Iríbar, B Peinado; Elola-Olaso, A. Moreno; Migueláñez, Isabel Pascual; Casas, Sara Gortázar de las; Crespo, Guillermo; Pardo, Ricardo; Chiloeches, Alba García; Puerta, Ana; González, R Maqueda; García, L Colao; González, J Serrano; O’Sullivan, Sara; Haro, Camila; Vaquero, M.A. Pérez; Nieto, Aroa; Vera-Mansilla, Cristina; Pérez-González, María Carmen; Schüte, S. Soto; Argüeso, A. Sanchez; Hernández-Villafranca, Sergio; Zhang, S Qian; Gorosabel, M; García, Javier; García, L Casalduero; Gamarra, M. Florez; Andrés, Jorge; Iglesias, Borja; Gutiérrez, V.; Perez, Franklin; Aparicio-Sánchez, Daniel; Durán-Muñoz-Cruzado, V M; Pareja-Ciuró, Felipe; Cano-Valderrama, Óscar; Avellana, R; Torres-Garcia, A. J.; Obrador, Leire Zaraín; Luengas, D Fernández; Ureña, Miguel Ángel García; Vázquez, Carlos Toribio; Fuenmayor-Valera, M. L.

doi:10.1093/bjs/znaa022

Cited by 1 publication

(1 citation statement)

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“…26 studies described a change in case number of appendicitis and/or appendectomies between comparable time periods before and during the COVID-19 pandemic in adults [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ]. Studies were conducted in 15 countries (as shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

Köhler

Müller

Hendricks

et al. 2021

International Journal of Surgery

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Background During the COVID-19 pandemic in 2020 a decrease of emergency consultations and modification in treatment of numerous medical conditions were observed. Aim of this paper was to evaluate the effect of the COVID-19 pandemic on incidence, treatment strategies, severity, length of hospital stay and time of presentation in adults and children with acute appendicitis. Methods A systematic literature search of Pubmed, Embase and Cochrane databases was performed, and eligible studies used to perform a meta-analysis. Results 46 suitable studies were identified with an overall reduction of appendicitis cases by 20.9% in adults and an increase of 13.4% in children. The rate of open appendectomies increased without statistical significance in both groups (adults: 8.5% vs. 7.1%, P = 0.32; children: 7.1% vs. 5.3%, P = 0.13), whereas the rate of antibiotic treatment increased significantly (P = 0.007; P = 0.03). Higher rates of complicated appendicitis were observed in adults (adults: OR 2.00, P < 0.0001; children: OR 1.64, P = 0.12). Time to first consultation did not change significantly (adults: 52.3 vs. 38.5 h – P = 0.057; children: 51.5 vs. 32.0 h – P = 0.062) and length of stay was also not lengthened during the pandemic (adults: 2.9 vs. 2.7 days, P = 0.057; children: 4.2 vs. 3.7 days, P = 0.062). Conclusion The COVID-19 pandemic of 2020 had major impact on incidence and treatment strategies of acute appendicitis. Results of this meta-analysis might be another hint to support the theory that appendicitis is not a progressive disease and surgeons can safely consider antibiotic therapy for acute uncomplicated appendicitis.

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