Ann Surg Treat Res.  2021 Oct;101(4):240-246. 10.4174/astr.2021.101.4.240.

Impact of COVID-19 on the care of acute appendicitis: a single-center experience in Korea

• Kim CW
• Lee SH

• KMID: 2520655
• DOI: http://doi.org/10.4174/astr.2021.101.4.240

Abstract

Purpose
Coronavirus disease 2019 (COVID-19) affects healthcare systems worldwide; however, few studies have assessed the impact of COVID-19 on emergent surgical diseases. This study aimed to investigate the impact of COVID-19 on the care given to patients with acute appendicitis in Korea.
Methods
Between November 2019 and November 2020, 495 patients underwent laparoscopic surgery for acute appendicitis. The patients were divided into prepandemic and pandemic groups. The baseline characteristics and perioperative outcomes were compared.
Results
The time between admission and surgery was longer in the pandemic group than in the prepandemic group (17.6 hours vs. 9 hours, P < 0.001). The operation time was longer (5.8 minutes, P = 0.014), inflammation was more severe (10%, P = 0.036), and more patients visited the emergency room (82.1% vs. 73.3%, P = 0.025) in the pandemic group than in the prepandemic group. There were no significant differences in postoperative complications or length of hospital stay between the 2 groups. After propensity score matching, the time to surgery was delayed (17.3 hours vs. 9 hours, P < 0.001) and more patients visited the emergency room (84.5% vs. 73.3%, P = 0.020) in the pandemic group.
Conclusion
In the COVID-19 era, the characteristics of patients with acute appendicitis and inflammation worsened. The time to surgery was delayed due to the requirement for preoperative COVID-19 testing and increased the severity of appendicitis did not affect the perioperative outcomes.

Keyword

Appendectomy; Appendicitis; COVID-19; Delivery of health care, Pandemics