The effect of COVID-19 pandemic period on acute appendicitis and its complications

BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency. This new type of coronavirus, also called SARS-CoV-2, causes severe acute respiratory syndrome, and this has turned into a pandemic. We aimed to determine the risk factors associated with appendectomy and complicated appendicitis during the COVID-19 pandemic period and to evaluate the effects on the surgical treatment of acute appendicitis and its outcomes. In the current comparative study, we analyzed its effects on appendectomy management and complicated appendicitis in patients with appendicitis during the COVID-19 pandemic and past year covering the same period.
METHODS: The patients in this study consisted of adult patients with acute appendicitis who applied to the Emergency Surgery Department of Kartal Dr. Lütfi Kýrdar City Hospital General Surgery Clinic between March 1, and August 31, 2020 (COVID-19 pe-riod) (Group B) and the same period of 2019 (Group A). A comparative and retrospective study was planned. A total of 658 patients who presented with acute appendicitis were included in the study. Group A and Group B consist of 347 and 311 people, respectively.
RESULTS: No significant difference was found in the demographic and clinical characteristics of the study population. There was no significant difference between Group A and B in terms of the duration of the application of patient complaints, the duration of the procedure, the time the patient was admitted to the hospital, the time of the patient being taken to the surgery, the findings during the operation, and the post-operative complications. There were similar features in general appendectomy pathologies, but in our study, a significant decrease in catarrhal appendicitis was observed in Group B, namely, during the COVID-19 pandemic period (p=0.04).
CONCLUSION: During the COVID-19 pandemic, there was no significant increase in complicated appendicitis, but a significant reduction in negative appendectomies. This result shows that during the pandemic period, patients do not come to the emergency surgery unit unnecessarily and receive timely and appropriate surgical care.

COVID-19 pandemi döneminin akut apandisit ve komplikasyonlarý üzerine etkisi

AMAÇ: Akut apandisit, en yaygýn abdominal cerrahi acil durumdur. SARS-CoV-2’de koronavirüsün bu yeni tipi ciddi akut solunum yolu sendromuna neden olmaktadýr ve bu durum küresel çapta bir pandemiye dönüþmüþtür. COVID-19 pandemi döneminde apendektomi ve komplike apandisit ile iliþkili risk faktörlerini belirlemek akut apandisit cerrahi tedavisi ve sonuçlarý üzerindeki etkilerini deðerlendirmeyi amaçlanmýþtýr. Mevcut karþýlaþtýrmalý çalýþma, COVID-19 pandemisi sýrasýnda ve ayný dönemi kapsayan geçen yýl apandisitli hastalarda apendektomi yöntemi ve komplike apandisit üzerine etkileri analiz edildi.
GEREÇ VE YÖNTEM: Bu çalýþmadaki hastalar 1 Mart–31 Aðustos 2020 COVID-19 pandemisi döneminde (Grup B) ve 2019 yýlýnýn ayný döneminde (Grup A) Kartal Dr. Lütfi Kýrdar Þehir Hastanesi Genel Cerrahi Kliniði Acil Cerrahi Bölümü’ne baþvuran akut apandisitli yetiþkin hastalardan oluþmaktadýr. Bu çalýþma, karþýlaþtýrmalý ve geriye dönük bir çalýþma olarak planlandý. Çalýþmaya akut apandisit ile baþvuran toplam 658 hasta alýndý. Grup A 347 hastadan oluþurken, Grup B 311 hastayý içeriyordu.
BULGULAR: Çalýþma popülasyonunun demografik özellikleri ve klinik özelliklerinde anlamlý bir farklýlýk görülmedi. Hasta þikayetlerinin baþvuru süresi, hastanýn hastaneye geliþ ile ameliyata alýnma süresi, ameliyat esnasýndaki bulgular ve ameliyat sonrasý komplikasyonlarda da Grup A ve B arasýnda da anlamlý bir fark görülmedi. Genel apendektomi patolojilerinde benzer özellikler mevcuttu ancak çalýþmamýzda Grup B de yani COVID-19 pandemi döneminde kataral apandisitte istatistiksel olarak anlamlý derecede azalma görüldü (p=0.04).
TARTIÞMA: COVID-19 pandemisi sýrasýnda komplike apandisitte önemli artýþ görülmedi ancak negatif apendektomilerde önemlide derecede azalma görüldü. Bu sonuç pandemi döneminde hastalarýn gereksiz acil cerrahi birimine gelmediklerini ve zamanýnda ve uygun cerrahi bakým aldýklarýný göstermektedir.