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

  • Achmad Musa ,
  • Marjono Dwi Wibowo ,
  • Denny Septarendra ,

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.

References

  1. Ferris M, Quan S, Kaplan BS, et al. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Ann Surg. 2017;266(2):237-241. doi:10.1097/SLA.0000000000002188.
  2. Krzyzak M, Mulrooney SM. Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus. 2020;12(6):e8562. Published 2020 Jun 11. doi:10.7759/cureus.8562.
  3. van Dijk ST, van Dijk AH, Dijkgraaf MG, Boermeester MA. Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. Br J Surg. 2018;105(8):933-945. doi:10.1002/bjs.10873.
  4. Temple CL, Huchcroft SA, Temple WJ. The natural history of appendicitis in adults. A prospective study. Ann Surg. 1995;221(3):278-281. doi:10.1097/00000658-199503000-00010.
  5. Eldar S, Nash E, Sabo E, et al. Delay of surgery in acute appendicitis. Am J Surg. 1997;173(3):194-198. doi:10.1016/s0002-9610(96)00011-6.
  6. Garst GC, Moore EE, Banerjee MN, et al. Acute appendicitis: a disease severity score for the acute care surgeon. J Trauma Acute Care Surg. 2013;74(1):32-36. doi:10.1097/TA.0b013e318278934a.
  7. Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-1207. doi:10.1056/NEJMoa2001316.
  8. Turanli S, Kiziltan G. Did the COVID-19 Pandemic Cause a Delay in the Diagnosis of Acute Appendicitis?. World J Surg. 2021;45(1):18-22. doi:10.1007/s00268-020-05825-3.
  9. Cano-Valderrama O, Morales X, Ferrigni CJ, et al. Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study. Int J Surg. 2020;80:157-161. doi:10.1016/j.ijsu.2020.07.002.
  10. Reichert M, Sartelli M, Weigand MA, et al. Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. World J Emerg Surg. 2020;15(1):64. Published 2020 Dec 9. doi:10.1186/s13017-020-00341-0.
  11. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557-564. doi:10.1016/s0196-0644(86)80993-3.
  12. Chang YJ, Chen LJ, Chang YJ. Did the severity of appendicitis increase during the COVID-19 pandemic?. PLoS One. 2022;17(2):e0263814. Published 2022 Feb 10. doi:10.1371/journal.pone.0263814.
  13. Lin KB, Lai KR, Yang NP, et al. Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study. World J Emerg Surg. 2015;10:42. Published 2015 Sep 17. doi:10.1186/s13017-015-0036-3.
  14. Stein GY, Rath-Wolfson L, Zeidman A, et al. Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis. Langenbecks Arch Surg. 2012;397(7):1087-1092. doi:10.1007/s00423-012-0958-0.
  15. Omari AH, Khammash MR, Qasaimeh GR, Shammari AK, Yaseen MK, Hammori SK. Acute appendicitis in the elderly: risk factors for perforation. World J Emerg Surg. 2014;9(1):6. Published 2014 Jan 15. doi:10.1186/1749-7922-9-6.

How to Cite

Achmad Musa, Marjono Dwi Wibowo, & Denny Septarendra. (2022). Comparison of acute appendicitis severity in pandemic and non-pandemic periods of COVID-19: a comparative study. Bali Medical Journal, 11(2), 609–613. https://doi.org/10.15562/bmj.v11i2.3565

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