Impact of the COVID-19 pandemic on the pattern of acute appendicitis, a single-center study.

BACKGROUND

Acute appendicitis is a common surgical emergency. During the COVID-19 pandemic, a decline in emergency department visits for various conditions, including appendicitis, was noted.

OBJECTIVE

To evaluate changes in the number, clinical presentation, and surgical approach of appendectomies performed during the COVID-19 lockdown compared to a pre-pandemic period.

DESIGN

Retrospective cohort study.

PATIENTS: All patients who underwent appendectomy for acute appendicitis during the lockdown months (March-May 2020 and 2021) were compared to those who had appendectomy during the same months in 2018-2019.

MAIN OUTCOME MEASURES: The rates of complicated (perforated) appendicitis, total number of procedures, and surgical modality (open vs. laparoscopic) were compared between the two periods.

RESULTS

A total of 252 patients were included. During the pandemic period, 19.4% of patients presented with a perforated appendix vs. 9.3% in the pre-pandemic group (p = 0.045, OR = 2.46). A significant decrease in the total number of appendectomies was observed during the pandemic (p < 0.001). Additionally, the proportion of open appendectomies increased during the lockdown.

CONCLUSION

In our study, the COVID-19 lockdown was associated with a significant increase in the rate of perforated appendicitis, a reduction in hospital-treated cases, and a higher rate of open surgery. These findings may suggest delayed patient presentation during the pandemic or a relative decrease in less severe cases.