Retrospective analysis of the incidence and time to care of acute appendicitis in the context of the COVID-19 pandemic: A descriptive cross-sectional study

Abstract

Introduction: The COVID-19 pandemic generated a major change in emergency department attendance. The aim of this article was to evaluate the incidence of acute appendicitis, the most frequent surgical emergency, between 2019 and
2020, as well as to compare the time of emergency department attendance, the stage of appendicitis and the need for admission to critical units. Material and Methods: Retrospective descriptive cross-sectional study. Patients operated on for
acute appendicitis between 2019 and 2020 in a private health institution in Lima, Peru were included. Data were obtained by review of medical records. Percentages were used for categorical variables, and chi-square was used for comparison effect. Results: 490 patients were included. In 2019 there were 290 patients operated for acute appendicitis, while in
2020 there were 200. In both cases the laparoscopic approach was the most frequent. Significantly longer delays were reported in emergency department attendance, with more patients attending 37 - 48 hours (4.5% vs 9.0%) and more than 61 hours (1.4% vs 9.0%) after the onset of the clinical picture. No significant differences were found in the stage of
appendicitis reported by pathology but there was a non-significant increase in appendicitis complicated by peritonitis (4.1% vs 7.0%). Conclusions: During the COVID-19 pandemic, a decrease in the incidence of acute appendicitis was observed, associated with a longer delay in emergency department attendance and a non-significant increase in peritonitis due to
acute appendicitis.