Comparison of acute appendicitis severity in pandemic and non-pandemic periods of COVID-19: a comparative study

Abstract

Background: Acute appendicitis is the most common cause of abdominal surgery. The delay of diagnosis and surgery increases the risk of perforated appendicitis, which is associated with increased morbidity and mortality. The COVID-19 pandemic has an impact on the delays in the diagnosis (time-to-diagnosis) and therapy (time-to-intervention). In this study, we aimed to analyze the profiles and characteristics of acute appendicitis patients in COVID-19 pandemic and non-pandemic periods in Indonesia. Methods: We collected samples from all patients with acute appendicitis who visited the emergency department from November 10, 2018 – February 10, 2020 (non-COVID-19 pandemic) and March 11, 2020 – August 11, 2021 (COVID-19 pandemic). The data are secondary data taken from medical records. We collected the patient’s demographic data (e.g., age and sex), operation description, length of stay, and duration of the operation. Results: We recruited a total of 121 patients, consisting of 56 patients during the non-pandemic period and 65 patients during the pandemic. Based on the severity, patients with grade 1 were the most common during the non-pandemic period, while patients with grade 4 were the most common during the pandemic. There was a significant difference between the severity of acute appendicitis during the non-pandemic and the pandemic (P < 0.0001). During non-pandemic periods, the majority of patients were hospitalized for 3-4 days, while during the pandemic, the majority of patients required hospitalization of up to 5-6 days. Conclusion: There was a substantial difference in the severity of acute appendicitis patients during the COVID-19 pandemic and non-pandemic periods.