Comparative Analysis Of The Management Of Acute Appendicitis Between The Normal Period And COVID-19 Pandemic

Abstract

BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency. There is no adequate information to evaluate the effects of the COVID-19 pandemic on acute appendicitis and its surgical management. The present comparative study reports successful appendectomy and infection control in patients with appendicitis during the COVID-19 pandemic and last year covering the same period. METHODS: This retrospective observational study was conducted in acute appendicitis-treated patients from 13.03.19 to 13.05.19 and from 13.03.20 to 13.05.20, respectively. RESULTS: This study included 150 patients (110 patients in 2019; 40 patients in 2020 (during COVID-19 pandemic)). The patients were named as Group A (Normal period) and Group B (Pandemic period), respectively. The groups were comparable as there was no significant difference between the mean age, mean BMI, and mean length of stay. There is a significant difference between the comorbidities of Group A and Group B (p=0.033). There was no significant difference between the laboratory and radiological findings of Group A and Group B. There was a significant difference between the perforation number of Group A and Group B (p=0.029). There was no significant difference between the needs of ICU and conversion from laparoscopic to conventional appendectomy of Group A and Group B. CONCLUSION: The findings obtained in this study suggest that late admission to the hospital caused complicated cases and made acute appendicitis management more difficult during the pandemic period, which was already a troubling period. During the COVID-19 pandemic, the principles applied to emergency surgery for infected patients should be applied to both suspected and confirmed cases.

Does the Covid-19 pandemic have an effect on wound culture in patients undergoing appendectomy? A Case Control Study

“…It has been reported to prolong the hospital stay and duration of antibiotic use of the patients and the number of non-perforated acute appendicitis decreased significantly while the number of perforated acute appendicitis increased during the pandemic period. [33][34][35] Our study was found to be compatible with the literature in this respect. This situation makes us think that the increase in the incidence of hospitalacquired infectious agents in public due to prolonging of hospital stay may be a result of the pandemic.…”

A Comparison of Pediatric Appendicitis During the COVID-19 Pandemic and the Same Period Previous Year

“…They also argued that the COVID-19 outbreak was effective in emergency surgeries as in all other surgical cases (8). Likewise, Meric et al stated that the number of patients decreased significantly during the pandemic (10). We concluded that the number of patients operated on for appendicitis during the pandemic decreased by 48.2% compared to the previous year, and these results are consistent with the literature.…”

“…The studies conducted during the pandemic observed a decrease in non-COVID-19 emergencies (10). In this study, we examined appendicitis cases since they constitute an important part of emergency attendance in pediatric surgery.…”

Changes in hospital admissions and complications of acute appendicitis during the COVID-19 pandemic: A systematic review and meta-analysis

“…days No. patients Age * Perforated or complicated Bajomo [55] United Kingdom 1,222 60 36 26.5 29% 60 42 30.5 21% Baugh [56] United States ¶ 611 59 150 NR NR 59 191 NR NR Burgard [57] Switzerland ¶ 712 84 65 29 52% 84 241 30 8% Ganesh [58] United Kingdom 1,407 414 32 37 NR 139 64 37 NR Mai [59] United Kingdom 1,916 61 39 34.4 61% 62 50 29.1 38% Maneck [60] Germany ¶ 841 40 2,914 34.5 NR 42 3591 32.7 NR Meriç [61] Turkey 680 60 40 34 18% 60 110 29.1 6% Orthopoulos [62] …”