Appendicitis as a presentation of COVID-19: A case report

Area of Science:

• Gastroenterology
• Infectious Diseases
• Surgical Case Reports

Background:

• Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, primarily presents with respiratory symptoms.
• A subset of patients exhibit gastrointestinal symptoms, sometimes mimicking acute surgical conditions like appendicitis.
• High index of suspicion for COVID-19 is warranted in acute abdomen cases during the pandemic.

Observation:

• A 25-year-old male presented with symptoms suggestive of acute appendicitis (Alvarado's score 7).
• Initial COVID-19 RT-PCR and chest X-ray were negative; appendectomy was performed.
• Post-operatively, the patient developed a fever, leading to a positive COVID-19 RT-PCR test.

Findings:

• This case highlights the potential for COVID-19 to manifest with acute gastrointestinal symptoms, specifically appendicitis-like presentation.
• Clinical diagnosis of surgical abdomen in COVID-19 patients can be challenging due to overlapping symptoms.
• Appendicitis can be an initial presentation of SARS-CoV-2 infection.

Implications:

• Emphasizes the need for increased clinical vigilance regarding gastrointestinal manifestations of COVID-19.
• Suggests considering COVID-19 testing in patients presenting with acute abdominal pain, even with initial negative results.
• Highlights the importance of recognizing SARS-CoV-2 as a differential diagnosis for acute appendicitis.