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. 2021 May;221(5):1056-1060.
doi: 10.1016/j.amjsurg.2020.09.026. Epub 2020 Sep 28.

Increasing incidence of complicated appendicitis during COVID-19 pandemic

Georgios Orthopoulos  1 , Elizabeth Santone  2 , Francesca Izzo  2 , Michael Tirabassi  2 , Aixa M Pérez-Caraballo  2 , Nicole Corriveau  2 , Nicolas Jabbour  2
Affiliations

Increasing incidence of complicated appendicitis during COVID-19 pandemic

Georgios Orthopoulos et al. Am J Surg. 2021 May.

Abstract

Background: The novel coronavirus (COVID-19) strain has resulted in restrictions potentially impacting patients presenting with acute appendicitis and their disease burden.

Methods: All acute appendicitis admissions (281 patients) between 1/1/2018-4/30/2020 were reviewed. Two groups were created: 6 weeks before (Group A) and 6 weeks after (Group B) the date elective surgeries were postponed in Massachusetts for COVID-19. Acute appendicitis incidence and disease characteristics were compared between the groups. Similar time periods from 2018 to 2019 were also compared.

Results: Fifty-four appendicitis patients were categorized in Group A and thirty-seven in Group B. Those who underwent surgery were compared and revealed a 45.5% decrease (CI: 64.2,-26.7) in uncomplicated appendicitis, a 21.1% increase (CI:3.9,38.3) in perforated appendicitis and a 29% increase (CI:11.5,46.5) in gangrenous appendicitis. Significant differences in the incidence of uncomplicated and complicated appendicitis were also noted when comparing 2020 to previous years.

Conclusions: The significant increase in complicated appendicitis and simultaneous significant decrease in uncomplicated appendicitis during the COVID-19 pandemic indicate that patients are not seeking appropriate, timely surgical care.

Keywords: Acute appendicitis; COVID-19; Complicated appendicitis.

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