Impact of the SARS-COV2 on Surgical Treatment of Acute Appendicitis: A Retrospective Cohort Multi-Centre Study

Author(s): Jeremi Bedard Ginchereau, Marc-André Bellavance, Anthonie Hamel, Nicolas Tasse, Sebastien Drolet

Background

Since the pandemic begun, in March 2020, several observational studies attempted to demonstrate the impact of the pandemic on the management of acute appendicitis. As a result, the surgical management of acute appendicitis is still undefined.

Method

A retrospective, cohort, observational study design was used to collect data from electronic medical records between March 13 and June 30, 2020 and the prior year, i.e 2019. All patients over 18 years of age admitted for acute appendicitis and treated surgically were initially included in our study. Timeframes observed in strategic intervals of hospitalization, postoperative complications and 30-days re-consultation rate were collected for analysis.

Results

A total of 371 out of 384 patients were included in the final analysis, i.e. 191 in the PRECOV group and 180 in the COV group. The rate of complicated appendicitis was similar between COV and PRECOV groups (33.9% vs 36.2%, p = 0.6647). However, the LOS was increased in the COV group (1.45 days vs 1.25 days, p = 0.0378). Patients operated during pandemic presented a complication rate similar to patients surgically treated for acute appendicitis before the pandemic (12.8% vs 11.0%, p = 0.6322).

Conclusions

Rate of complicated cases of appendicitis remained similar during the pandemic compared to the pre-pandemic period. The LOS significantly increased during the pandemic, owing mainly to an extended time-to-surgery period. Thus the impact of the pandemic is real, the observed delays seem to be mostly related to the pressure exerted on the system rather than the intrinsic pathology.