Comparison of Perforated Appendicitis Prior to and Post quarantine during COVID19 Pandemic

Abstract

Background: The SARS-CoV-2 virus has caused patient aversion to health care facilities for fear of contracting the virus. It has been shown that there has been a decreased amount of emergency department visits since the pandemic started1, with an increased presentation of conditions with progressed pathology. At our community hospital, it was anecdotally noted that there was an increase in the number of patients presenting with perforated appendicitis during this time. Our hypothesis is that more patients presented with the progressed finding of perforated appendicitis during rather than prior to the pandemic because of fear of exposure to COVID-19 in the health care setting. Methods: Retrospective chart review of cases of perforated appendicitis at a local community hospital during March 10-December 31, 2019 (cohort A) and March 10-December 31, 2020 (cohort B).Results: A total of three hundred and fifty-two eligible patients received treatment for acute appendicitis at our community hospital. In Cohort A (prior to the pandemic), there were 53 perforations out of 188 patients (53/188) - 28.2%. In cohort B (during the pandemic), there was 61 perforations out of 164 patients (61/164) – 37.2%. Statistically, there was no difference in the rate of perforation between Cohort A and Cohort B, approaching significance (p-value = 0.072). The median age of patients in Cohort A was 38 and in Cohort B it was 43.5 years of age. There was no statistically significant differences between cohorts regarding age (p < 0.23) and sex (p < 0.8). Conclusion: This study found that the number of patients who presented with perforated appendicitis during the pandemic did increase compared to pre-pandemic (37.2% vs 28.2%) but this did not meet statistical significance (p=0.072).