Effect of the COVID-19 pandemic on patients with presumed diagnosis of

Abstract

BACKGROUNDAcute appendicitis (AAp) is the most frequent cause of acute abdominal pain, and appendectomy is the most frequent emergency procedure that is performed worldwide. The coronavirus disease 2019 (COVID-19) pandemic has caused delays in managing diseases requiring emergency approaches such as AAp and trauma.AIMTo compare the demographic, clinical, and histopathological outcomes of patients with AAp who underwent appendectomy during pre-COVID-19 and COVID-19 periods.METHODSThe demographic, clinical, biochemical, and histopathological parameters were evaluated and compared in patients who underwent appendectomy with the presumed diagnosis of AAp in the pre-COVID-19 (October 2018-March 2020) and COVID-19 (March 2020-July 2021) periods.RESULTSAdmissions to our tertiary care hospital for AAp increased 44.8% in the COVID-19 period. Pre-COVID-19 (n = 154) and COVID-19 (n = 223) periods were compared for various parameters, and we found that there were statistically significant differences in terms of variables such as procedures performed on the weekdays or weekends [odds ratio (OR): 1.76; P = 0.018], presence of AAp findings on ultrasonography (OR: 15.4; P < 0.001), confirmation of AAp in the histopathologic analysis (OR: 2.6; P = 0.003), determination of perforation in the appendectomy specimen (OR: 2.2; P = 0.004), the diameter of the appendix (P < 0.001), and hospital stay (P = 0.003). There was no statistically significant difference in terms of interval between the initiation of symptoms and admission to the hospital between the pre-COVID-19 (median: 24 h; interquartile range: 34) and COVID-19 (median: 36 h; interquartile range: 60) periods (P = 0.348). The interval between the initiation of symptoms until the hospital admission was significantly longer in patients with perforated AAp regardless of the COVID-19 or pre-COVID-19 status (P < 0.001).CONCLUSIONThe present study showed that in the COVID-19 period, the ultrasonographic determination rate of AAp, perforation rate of AAp, and duration of hospital stay increased. On the other hand, negative appendectomy rate decreased. There was no statistically significant delay in hospital admissions that would delay the diagnosis of AAp in the COVID-19 period.

C1 [Akbulut, Sami; Sahin, Tevfik Tolga; Koc, Cemalettin; Karabulut, Ertugrul] Inonu Univ, Surg & Liver Transplant Inst, Fac Med, TR-44280 Malatya, Turkey.

[Akbulut, Sami; Guldogan, Emek] Inonu Univ, Dept Biostat & Med Informat, Fac Med, TR-44280 Malatya, Turkey.

[Akbulut, Sami; Ozer, Ali] Inonu Univ, Dept Publ Hlth, Fac Med, TR-44280 Malatya, Turkey.

[Tuncer, Adem; Ogut, Zeki] Inonu Univ, Dept Surg, Fac Med, TR-44280 Malatya, Turkey.

[Tanriverdi, Elif Seren] Inonu Univ, Dept Med Microbiol, Med Fac, TR-44280 Malatya, Turkey.

[Akbulut, Sami] Inonu Univ, Surg & Liver Transplant Inst, Fac Med, Elazig Yolu 10 Km, TR-44280 Malatya, Turkey.

C3 Inonu University; Inonu University; Inonu University; Inonu University;

Inonu University; Inonu University