SARS-CoV-2 infection and complicated appendicitis in adults in Lima, Peru: a matched case-control study

Area of Science:

• Infectious Diseases
• Gastrointestinal Surgery
• Epidemiology

Background:

• Acute appendicitis can be uncomplicated or complicated, with life-threatening outcomes.
• The COVID-19 pandemic has seen a rise in complicated appendicitis cases, hinting at a potential link.
• This study investigated the association between SARS-CoV-2 infection and complicated appendicitis in Peruvian surgical patients.

Purpose of the Study:

• To determine the association between SARS-CoV-2 infection and complicated appendicitis.
• To assess the risk of complicated appendicitis in patients with COVID-19.

Main Methods:

• A matched case-control study was conducted.
• Patients aged 18+ undergoing appendicitis surgery with positive SARS-CoV-2 tests were included.
• Cases had complicated appendicitis; controls had uncomplicated appendicitis, matched 1:1 by sex, age, and surgery month.

Main Results:

• COVID-19 positivity was 73.6% in complicated appendicitis cases versus 26.4% in controls.
• The crude odds ratio for complicated appendicitis with SARS-CoV-2 infection was 4.88.
• The adjusted odds ratio remained significant at 3.52 after controlling for symptom onset and pre-surgery waiting times.

Conclusions:

• A significant association exists between SARS-CoV-2 infection and complicated appendicitis.
• Patients with SARS-CoV-2 infection may face an elevated risk of developing complicated appendicitis.
• Enhanced clinical monitoring is recommended for patients with COVID-19 due to this increased risk.