RT Journal Article
SR Electronic
T1 Acute appendicitis severity during the early COVID-19 pandemic period
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000809
DO 10.1136/tsaco-2021-000809
VO 6
IS 1
A1 Thomas D Zaikos
A1 Elizabeth M Boudiab
A1 Emanuela C Peshel
A1 Annie A Wu
A1 Ethan Dyer
A1 Elliott R Haut
A1 Kevan J Salimian
YR 2021
UL http://tsaco.bmj.com/content/6/1/e000809.abstract
AB Background The early COVID-19 pandemic period significantly strained the US healthcare system. During this period, consultations and admissions for acute medical conditions decreased, which was associated with an increase in disease-specific morbidity and mortality. Therefore, we sought to determine what, if any, effect the early COVID-19 pandemic period had on the presentation, management, and histopathologic severity of acute appendicitis.Methods We performed a retrospective, observational study to compare the frequencies with which patients presented with acute appendicitis, the proportion of whom were managed surgically, and the distribution of histopathologic disease severity among all resected appendix specimens during the early COVID-19 pandemic period (March 6–June 30, 2020) to equivalent time periods for the 3 preceding/pre-pandemic years (2017–2019).Results Compared with equivalent pre-pandemic time periods, during the COVID-19 pandemic period there was no significant difference in the number of patients who presented for acute appendicitis, there was a decreased rate of surgical management (81% vs 94%; p=0.014), and there was an overall increase in the incidence of perforated appendicitis (31% vs 16%; p=0.004), including by histopathologic diagnosis (25% vs 11%; p=0.01).Discussion Despite potential patient hesitancy to present for care, the early COVID-19 pandemic period was associated with no significant change in the number of patients presenting with acute appendicitis; however, there was a significant increase in the incidence of perforated appendicitis. This study highlights the need to encourage patients to avoid late presentation for acute surgical conditions and for the robust planning for the medical management of otherwise surgical abnormalities during episodes of restricted or limited resources.Level of evidence Level III.