Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown

Area of Science:

• Medicine
• Epidemiology
• Surgical Outcomes

Background:

• New York City was an early epicenter of the COVID-19 pandemic in spring 2020.
• The pandemic significantly impacted healthcare systems globally, necessitating evaluation of its effect on common surgical conditions.

Purpose of the Study:

• To evaluate the incidence and treatment outcomes of acute appendicitis in NYC community hospitals during the COVID-19 pandemic.
• To compare appendicitis patient data during peak COVID-19 periods with pre-COVID and post-COVID periods.

Main Methods:

• Retrospective study of adult patients (>18 years) with acute appendicitis.
• Comparison of operative vs. nonoperative management, demographics, length of stay (LOS), complications, and readmission rates.
• Data analyzed for pre-COVID, peak-COVID (March 16-June 15, 2020), and post-COVID periods.

Main Results:

• A significant reduction in weekly appendicitis presentations was observed during the peak COVID-19 period (4.4 cases/week) compared to pre-COVID (6.9) and post-COVID (7.6) periods (P=0.018).
• No significant differences were found in length of stay (median 1 day), 30-day readmission rates (0% during peak COVID), or postoperative complications (0% during peak COVID) across the periods.
• Operative management was utilized for 81.7% of cases during the peak COVID period, similar to 2019 (83%).

Conclusions:

• The COVID-19 pandemic led to a significant decrease in acute appendicitis presentations without a subsequent rebound.
• Patients presenting with appendicitis during the peak COVID-19 period could undergo safe operative management.
• No adverse impact on length of stay or postoperative complications was observed for appendicitis patients during the peak COVID-19 period.