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Acute Appendicitis During The COVID-19 Pandemic: A Multicenter, Retrospective Analysis From The US Epicenter
Richard Tamirian1, Michael Klein1,2, Patricia Chui1,2
1Department of Surgery, New York University Grossman School of Medicine, New York, NY, USA.
The American Surgeon
|May 23, 2022
Summary
During the COVID-19 pandemic, acute appendicitis (AA) incidence decreased significantly. Patients presented with more complicated disease due to delayed presentation, and non-operative management increased.
Area of Science:
- Emergency Medicine
- Surgical Outcomes
- Infectious Disease Epidemiology
Background:
- Acute appendicitis (AA) is a common surgical emergency with a stable incidence.
- The COVID-19 pandemic significantly impacted healthcare utilization for non-COVID conditions.
- Hospitals observed a reduction in patients presenting with diseases like AA during the pandemic's peak.
Purpose of the Study:
- To analyze the impact of the COVID-19 pandemic on the incidence of AA.
- To investigate changes in the clinical presentation and management of AA during the pandemic.
- To compare AA cases during the pandemic peak with a pre-pandemic control group.
Main Methods:
- Retrospective analysis of AA patients at two academic medical centers.
- Comparison of data from the COVID-19 peak (March-May 2020) with the same period in 2019.
- Statistical analysis using Mann-Whitney U, Chi-square, and Fisher's exact tests.
Main Results:
- AA incidence dropped by 49.1% in 2020 compared to 2019.
- Median symptom duration doubled (1 day in 2019 vs. 2 days in 2020).
- Complicated appendicitis proportion increased from 19.3% to 41.4% in 2020.
Conclusions:
- Fewer patients with AA presented during the initial COVID-19 wave.
- Delayed presentation likely contributed to increased complicated appendicitis.
- Non-operative management for uncomplicated AA became more frequent during the pandemic.
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