Comparison of the effects of COVID-19 pandemic on acute appendicitis treatment and its clinical outcomes with the pre-COVID-19 pandemic period

We aimed to compare the rate of admission to the hospital, duration of symptoms, prior admission to an external center, laboratory values, risk of complication development, and length of hospitalization of patients diagnosed with acute appendicitis and undergoing appendectomy during the pre-covid-19 pandemic period and the covid-19 pandemic period. A total of 464 patients, male and female, over the age of 18, who were operated on with the diagnosis of acute appendicitis in Gaziantep University Medical Faculty Hospital General Surgery Clinic were included in our retrospective study. All patients underwent open appendectomy with the diagnosis of acute appendicitis. The recorded data of the patients in the archive of Gaziantep University Faculty of Medicine, Department of General Surgery and in the hospital database were examined.In both periods as pre-Covid-19 pandemic (11.03.2019-10.03.2020) and Covid-19 pandemic period (11.03.2020-10.03.2021); we compared these parameters; age, gender, admission status before applying to our center (admission to an external center), duration of symptoms after the onset of pain until admission to our center, delayed presentation (symptom duration more than 3 days), preoperative appendix diameter, CRP value, WBC value, type of incision, perforated appendicitis ,presence of abscess, complications, and length of hospital stay . Of the cases included in the study, 254 (54.7%) were admitted before the pandemic, and 210 (45.3%) were admitted during the pandemic period. Of the patients, 238 (51.3%) were female and 226 (48.7%) were male. The mean age of the patients was 35.34±14.89 years. Of the patients included in the study, 114 (24.6%) were patients who had previously applied to an external center. The mean duration of symptoms of the patients was 2.41±2.38 days, and there were 90 (19.4%) patients with symptom duration of more than 3 days and 374 (80.6%) patients with less than 3 days of symptom duration. The mean appendix diameter of the patients was 9.77 It was ±2.44 mm, mean CRP value was 51.90±68.81 mg/L, mean WBC value was 13.78x103/µL. McBurney incision was present in 389 (83.8%) patients, and midline incision was found in 75 (16.2%) patients. Perforation was observed in 79 (17.0%) of the patients, and periappendicular abscess was observed in 38 (8.2%) patients. Complicated appendicitis was present in 90 (19.4%) patients. The mean hospital stay of the patients was 3.54±2.61 days. In our study, it was found that only the duration of symptoms was prolonged during the pandemic period. As a result of our study, patients applied to our health center later due to the limitations in social life and fear of contamination during the pandemic period. The pandemic period did not increase the complication risk of acute appendicitis cases. Keywords: Acute appendicitis, pandemic, covid-19, acute abdomen, duration of symptoms