Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Abstract

Objectives To assess the prevalence of complicated appendicitis (including gangrene, abscess and perforation) after the outbreak of the 2019-nCoV epidemic and to identify the risk factors associated with complicated appendicitis. Methods Two groups were established in the study consisting of: one group for cases of acute appendicitis before the 2019-nCoV epidemic (before January 1, 2020; pre-epidemic group) and another group for those after the epidemic outbreak (after January 1, 2020; epidemic group). These two groups were compared in terms of demographic and clinical characteristics, prevalence of complicated appendicitis, and treatment intention. A multivariate analysis model using binary logistic regression was constructed. Results A total of 163 patients were included in this study, with 105 in the pre-epidemic group and 58 in the epidemic group. In the epidemic group, the interval from the onset of symptoms to admission was 65.0 h, which is significantly longer than the 17.3 h interval noted in the pre-epidemic group ( P < 0.001). The prevalence of complicated appendicitis after the epidemic outbreak was significantly higher than before the outbreak (51.7% vs. 12.4%, P < 0.001). In addition, the epidemic group had a lower score of patient’s intention to seek treatment than the pre-epidemic group (9.5 ± 2.7 vs. 3.4 ± 2.6, P < 0.001). Based on the multivariate analysis, the risk factors for complicated appendicitis included the time from symptoms onset to admission (OR = 1.075) and the patients’ intention to receive treatment (OR = 0.541). Conclusion Complicated appendicitis was more common in patients with acute appendicitis after the outbreak of the 2019-nCoV epidemic.

Acute complex appendicitis during the COVID-19 epidemic: A single-institution retrospective analysis based on real-world data

“…[ 22 , 23 ] It is precisely in our study that during the epidemic period, the time interval from the onset of symptoms to medical treatment in patients with acute appendicitis was significantly prolonged, while the proportion of patients with suppurative appendicitis was higher, and the incidence of complex appendicitis was also higher. It has also been reported that the perforation rate of acute appendicitis in children increased during the epidemic, [ 7 ] and the incidence of complex appendicitis increased in the United States and other areas, [ 24 , 25 ] which is consistent with our research results.…”

The effect of national public health interventions for COVID‐19 on emergency general surgery in Northland, New Zealand

“…Concern has been raised that patients are presenting with increased disease severity in the COVID‐19 threatened climate. Literature from the UK, China, Spain, Australia and Colombia has shown increased severity of appendicitis in patients presenting in the COVID‐19 era compared to prior 12,19–22 . This study did not demonstrate an increased severity in patients presenting with diverticulitis, appendicitis or pancreatitis.…”

Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany

“…However, the usually low rate of very complicated cases of appendicitis does not allow an uncritical extrapolation of the current results to other surgical emergencies. A comparison with the international literature shows some parallels regarding a reduction in appendectomies [ 13 , 14 ], a later presentation, and an increased inflammatory reaction [ 5 , 15 – 18 , 20 , 31 ]. The international survey of Ielpo et al of more than 700 surgeons worldwide reported a decrease of appendicitis and an increase of complicated cases based on a questionnaire [ 20 ].…”