Impact of COVID-19 on Acute Appendicitis: Real-World Study at a Third-Level Hospital in Mexico City

Background Acute appendicitis (AA) is a common surgical emergency, with delayed diagnosis increasing the risk of complications. The COVID-19 pandemic disrupted healthcare access, potentially leading to more severe presentations of AA. This study assesses the pandemic's impact on the severity and outcomes of AA. Methods This retrospective cohort study analyzed patients diagnosed with AA at the American British Cowdray Medical Center from November 2019 to July 2020. The patients were categorized into pre-pandemic (before March 23, 2020) and post-pandemic (after March 24, 2020) groups. Demographics, laboratory findings, intraoperative classification with American Association for the Surgery of Trauma (AAST) grades I-V, histopathology, and duration of hospital stay were compared. Results Of the 192 patients included in the study, 119 were in the pre-pandemic group and 73 in the post-pandemic group. Although the post-pandemic group had longer symptom duration before hospital admission, the difference was not statistically significant (p=0.1078). However, the post-pandemic group had significantly more cases of complicated appendicitis (p=0.0012) and perforated appendicitis (p=0.0171). Histopathological analysis showed that post-pandemic patients were 1.8 times more likely to have complicated appendicitis (OR=1.8, 95% CI:1.3-2.6). The duration of hospital stay remained similar between groups (p=0.2957). Conclusions The COVID-19 pandemic led to delayed AA presentation and increased disease severity. Public health measures should stress the importance of prompt medical evaluation to prevent complications. Further studies are needed to explore additional factors influencing delays in surgical emergencies.