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Increasing incidence of complicated appendicitis during COVID-19 pandemic

Georgios Orthopoulos1, Elizabeth Santone1, Francesca Izzo1

  • 1Department of Surgery, University of Massachusetts Medical School -Baystate Medical Center, Springfield, MA, USA.

American Journal of Surgery
|October 5, 2020
PubMed

Insights

The COVID-19 pandemic led to more severe appendicitis cases, with fewer uncomplicated cases. Patients delayed seeking care, resulting in increased perforated and gangrenous appendicitis during the pandemic.

Area of Science:

  • Surgery
  • Infectious Diseases
  • Public Health

Background:

  • The novel coronavirus (COVID-19) pandemic imposed restrictions impacting healthcare access.
  • Patients with acute appendicitis may have experienced delays in seeking timely medical care.

Purpose of the Study:

  • To evaluate the impact of COVID-19 restrictions on appendicitis incidence and severity.
  • To compare appendicitis characteristics before and after elective surgery postponements.

Main Methods:

  • Retrospective review of 281 acute appendicitis admissions from 1/1/2018 to 4/30/2020.
  • Comparison of appendicitis cases in the 6 weeks before and 6 weeks after elective surgery postponements.
  • Analysis of appendicitis incidence and disease characteristics, including uncomplicated, perforated, and gangrenous cases.

Main Results:

  • A 45.5% decrease in uncomplicated appendicitis was observed post-restrictions.
  • A 21.1% increase in perforated appendicitis and a 29% increase in gangrenous appendicitis were noted.
  • Significant differences in appendicitis incidence and complexity were found when comparing 2020 to previous years.

Conclusions:

  • The COVID-19 pandemic was associated with a significant rise in complicated appendicitis.
  • Patients' delayed presentation for surgical care contributed to increased appendicitis severity.
  • Timely access to surgical care is crucial for managing acute appendicitis effectively.
Abstract

Keywords:
Acute appendicitisCOVID-19Complicated appendicitis

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