Influence of the coronavirus 2 (SARS-Cov-2) pandemic on acute appendicitis()

Velayos, María; Muñoz-Serrano, Antonio Jesús; Estefanía-Fernández, Karla; Sarmiento Caldas, Mª Carmen; Lapeña, Lucas Moratilla; López-Santamaría, Manuel; López-Gutiérrez, Juan Carlos

INTRODUCTION: Acute appendicitis (AA) is the most common abdominal surgical emergency. No specific studies have been found that evaluate the impact of the coronavirus 2 (SARS-Cov-2) pandemic on AA and its surgical management. An analysis was made on the influence of this new pathology on the clinical course of AA. MATERIAL AND METHODS: Retrospective observational study was conducted on patients operated on for AA from January to April 2020. They were classified according to the time of the appendectomy, before the declaration of the state of alarm (Pre-COVID-19), and after its declaration (Post-COVID-19) in Spain, one the most affected countries in the world. An evaluation was made of demographic variables, duration of symptoms, type of appendicitis, surgical time, hospital stay, and postoperative complications. RESULTS: The study included 66 patients (41 Pre-COVID-19; 25 Post-COVID-19) with mean age of 10.7 ± 3 and 9.3 ± 3.1; p = .073, respectively. Fever was found in a higher number of post-COVID-19 patients (52 vs 19.5%; p = .013), as well as a higher CRP (72.7±96.2 vs 31.3±36.2 mg/dL; p = .042). This group presented with a higher proportion of complicated appendicitis when compared to Pre-COVID-19 (32 vs 7.3%; p = .015). The mean hospital stay was longer in the Post-COVID-19 group (5.6±5.9 vs 3.2±4.3 days; p = .041). No differences were found in the time of onset of symptoms or surgical time. CONCLUSIONS: The SARS-Cov-2 pandemic influenced the time of diagnosis of appendicitis, as well as its course, and mean hospital stay. Peritonitis was more frequently seen. As a result of the significant circumstances, delaying diagnosis and treatment of AA during SARS-Cov-2 pandemic, inappropriate management of this common surgical disorder has been noticed.