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Acute Appendicitis During Coronavirus Disease 2019 (COVID-19): Changes in Clinical Presentation and CT Findings
Javier Romero1, Sergio Valencia1, Andres Guerrero1
1Fundación Santa Fe de Bogotá, Bogotá, Colombia.
Insights
During the COVID-19 pandemic, fewer patients sought care for appendicitis, leading to more severe cases. This study analyzed appendicitis presentation and CT findings during pandemic lockdowns.
Area of Science:
- Medical imaging and diagnostics
- Epidemiology
- Public health interventions
Background:
- Quarantine and stay-at-home orders were implemented globally during the COVID-19 pandemic to curb disease spread.
- Concerns arose that these mandates may have deterred patients from seeking essential medical care.
- This could potentially impact the presentation and severity of various medical conditions.
Purpose of the Study:
- To compare the clinical presentation and CT scan findings of acute appendicitis.
- To evaluate differences between the COVID-19 acute pandemic period and a comparable nonpandemic period.
- To assess the impact of pandemic-related restrictions on appendicitis diagnosis and severity.
Main Methods:
- A retrospective observational study design was employed.
- Data from 196 abdominal CT scans for suspected acute appendicitis were analyzed.
- The study compared the period of March 23, 2020, to May 4, 2020, with the same period in 2019.
Main Results:
- A higher proportion of CT scans diagnosed acute appendicitis during the pandemic period (45.5% vs. 29.8%, P = .038).
- Appendicitis cases diagnosed during the pandemic were significantly more severe (92% vs. 57.1%, P = .003).
- Fewer patients presented with appendicitis during the acute pandemic phase.
Conclusions:
- Fewer patients presented with acute appendicitis during the COVID-19 pandemic.
- Patients who did present had more advanced and severe cases of appendicitis.
- Pandemic restrictions likely influenced healthcare-seeking behavior and disease progression.
Background:
Quarantine and stay-at-home orders are strategies that many countries used during the acute pandemic period of coronavirus disease 2019 (COVID-19) to prevent disease dissemination, health system overload, and mortality. However, there are concerns that patients did not seek necessary health care because of these mandates.
Purpose:
To evaluate the differences in the clinical presentation of acute appendicitis and CT findings related to these cases between the COVID-19 acute pandemic period and nonpandemic period.
Materials And Methods:
A retrospective observational study was performed to compare the acute pandemic period (March 23, 2020, to May 4, 2020) versus the same period the year before (March 23, 2019, to May 4, 2019). The proportion of appendicitis diagnosed by CT and level of severity of the disease were reviewed in each case. Univariate and bivariate analyses were performed to identify significant differences between the two groups.
Results:
A total of 196 abdominal CT scans performed due to suspected acute appendicitis were evaluated: 55 from the acute pandemic period and 141 from the nonpandemic period. The proportion of acute appendicitis diagnosed by abdominal CT was higher in the acute pandemic period versus the nonpandemic period: 45.5% versus 29.8% (P = .038). The severity of the diagnosed appendicitis was higher during the acute pandemic period: 92% versus 57.1% (P = .003).
Conclusion:
During the acute COVID-19 pandemic period, fewer patients presented with acute appendicitis to the emergency room, and those who did presented at a more severe stage of the disease.
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