The effect of the COVID-19 pandemic on acute appendicitis cases

The COVID-19 outbreak has affected healthcare systems around the world, and has led to changes in the clinical and treatment approaches to all diseases. To reveal the reflection and negative effects of the psychological trauma associated with the COVID-19 pandemic among those with acute appendicitis. A retrospective analysis is made of the data of patients admitted to the emergency departments in our city (Trabzon, Turkey) and taken into operation. Comparative analysis of two patient groups diagnosed with acute appendicitis in our region was included in our study: In the COVID-19 pandemic period (Group 2); and on the same dates a year ago (Group 1). Groups 1 and 2 comprised 231 and 144 patients, respectively (p < 0.001). There was no statistically significant difference in the type of anesthesia between the groups (p = 0.280). There was no statistically significant difference between the groups in terms of median duration of surgery (p = 0.239). There was a statistically significant difference in the pathological diagnoses of Groups 1 and 2 (p < 0.001). Considering the pathological diagnoses, a significant difference was established in the duration of hospital stay of the cases, which was longer in patients diagnosed with perforated appendicitis (p < 0.001). It is apparent that during the COVID-19 outbreak, hospitals are associated with increased transmission risk, causing people to delay their referral to the emergency department, and leading to an increase in irreversible complications and mortality rates.

___

  • 1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020;395:565-574.
  • 2. Recurrent use of the Emergency Department in patients with anxiety disorder.F Buccelletti et al. Eur Rev Med Pharmacol Sci. 2013 Feb;17 1:100-6.
  • 3. Julian D Ford et al.Prospective association of anxiety, depressive, and addictive disorders with high utilization of primary, specialty and emergency medical care. Soc Sci Med.2004 Jun;58(11):2145-8.
  • 4. Alimoglu o, Erol CI. Approach To General Surgery Practice During COVID-19 Pandemic. Anadolu Kliniği Tıp Bilimleri Dergisi, Ocak 2020; Cilt 25, Özel Sayı 1
  • 5. De Simone B, Chouillard E, Di Saverio S, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. Ann R Coll Surg Engl. 2020;102(5):323-332.
  • 6. Hussain A, Mahawar K, El-Hasani S. The Impact of COVID-19 Pandemic on Obesity and Bariatric Surgery. Obes Surg. 2020;30(8):3222-3223.
  • 7. Birnbaum BA, Wilson SR. Appendicitis at the Millennium. Radiology 2000; 215: 337-348.
  • 8. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990; 132: 910-925.
  • 9. Yabanoglu H, Caliskan K, Ozgur Aytac H et al. Unusual findings in appendectomy specimens of adults: retrospective analyses of 1466 patients and a review of literature. Iran Red Crescent Med J 2014; 16: 12931.
  • 10. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis: nationwide analysis. Arch Surg 2002; 137: 799–804.
  • 11. .Jager RM. Diagnostic laparoscopy. In: Jager RM, Wexner SD(Eds). Laparoscopic colorectal surgery. New York, Churcill Livingstone. 1996:127-37
  • 12. Livingston EH, et al. Epidemiological similarities between appendicitis and diverticulitis suggesting a common underlying pathogenesis. Arch Surg. 2011;146(3): 308-314.
  • 13. Jones K, Pena AA, Dunn EL, Nadalo L, Mangram AJ. Are negative appendectomies still acceptable? Am J Surg 2004; 188: 748-754.
  • 14. Onuray F, Vural S, Tüzün B, et al. Negatif Apendektomilerdeki Jinekolojik Patoloji Oranımız. Uludağ Üniversitesi Tıp Fakültesi Dergisi 2005; 31: 21-23.
  • 15. Drazan KE, Corman ML. Large Bowel Obstruction In: Cameron JL(Ed). Current Surgical Therapy. Mosby. St. Louis. 1998.s:186-96.
  • 16. Hoffman J, Rasmussen OO. Aids in the diagnosis of acute appendicitis. Br J Surg. 1989;76: 774-9.
  • 17. Incesu L, Coskun A, Selcuk MB, Akan H, Sozubır S,Bernay F. Akut appendicitis MR imaging and sonographig correlation. Am J Roentgenol. 1997;168:669-74.
  • 18. Huston JM, Kao LS, Chang PK, et al. Antibiotics vs. appendectomy for acute uncomplicated appendicitis in adults: Review of the evidence and future directions. Surg Infect (Larchmt) 2017; 18: 527-535.
  • 19. Salminen P, et al. Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis. JAMA. 2015(23):2340-2348.
  • 20. Leonards LM, Pahwa A, Patel MK, et al. Neoplasms of the appendix: Pictorial review with clinical and pathologic correlation. Radiographics 2017; 37: 1059-1083.
  • 21. Çay F, Girgin M.Evaluation of the Laparoscopic Appendectomy Advantage and Disadvantages. Journal of Harran University Medical Faculty. 2018; 15: 31-35.
  • 22. Kamer E, Çolak T. What to Do When A Patient Infected With COVID-19 Needs An Operation: A Pre-surgery, Peri-surgery and Post-surgery Guide. Turk J Colorectal Dis 2020; 30: 1-8.