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

Affiliations
  • 1Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea

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

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Ann Surg Treat Res. 2022;103(2):104-111.    doi: 10.4174/astr.2022.103.2.104.


Reference

1. World Health Organization (WHO). WHO announces COVID-19 outbreak a pandemic [Internet]. Geneva: WHO;2020. cited 2021 Mar 15. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/who-announces-covid-19-outbreak-a-pandemic.
2. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study. Lancet. 2020; 396:27–38. PMID: 32479829.
3. Doglietto F, Vezzoli M, Gheza F, Lussardi GL, Domenicucci M, Vecchiarelli L, et al. Factors associated with surgical mortality and complications among patients with and without coronavirus disease 2019 (COVID-19) in Italy. JAMA Surg. 2020; 155:691–702. PMID: 32530453.
Article
4. Morris M, Pierce A, Carlisle B, Vining B, Dobyns J. Pre-operative COVID-19 testing and decolonization. Am J Surg. 2020; 220:558–560. PMID: 32466826.
Article
5. Veziant J, Bourdel N, Slim K. Risks of viral contamination in healthcare professionals during laparoscopy in the Covid-19 pandemic. J Visc Surg. 2020; 157:S59–S62. PMID: 32340900.
Article
6. National Health Insurance Service (NHIS). Main surgery statistical yearbook for 2019 [Internet]. Wonju: NHIS;2019. cited 2021 Mar 15. Available from: https://www.nhis.or.kr/nhis/together/wbhaec06800m01.do?mode=view&articleNo=10803657&article.offset=0&articleLimit=10.
7. CODA Collaborative, Flum DR, Davidson GH, Monsell SE, Shapiro NI, Odom SR, et al. A randomized trial comparing antibiotics with appendectomy for appendicitis. N Engl J Med. 2020; 383:1907–1919. PMID: 33017106.
Article
8. Javanmard-Emamghissi H, Boyd-Carson H, Hollyman M, Doleman B, Adiamah A, Lund JN, et al. The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study. Tech Coloproctol. 2021; 25:401–411. PMID: 32671661.
Article
9. Orthopoulos G, Santone E, Izzo F, Tirabassi M, Pérez-Caraballo AM, Corriveau N, et al. Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am J Surg. 2021; 221:1056–1060. PMID: 33012500.
Article
10. Bajomo O, Hampal R, Sykes P, Miah A. Managing appendicitis during the COVID-19 era: a single centre experience& implications for future practice. Ann Med Surg (Lond). 2021; 63:102168. PMID: 33614025.
11. Baral S, Chhetri RK, Thapa N. Comparison of acute appendicitis before and within lockdown period in COVID-19 era: a retrospective study from rural Nepal. PLoS One. 2021; 16:e0245137. PMID: 33406126.
Article
12. Finkelstein P, Picado O, Muddasani K, Wodnicki H, Mesko T, Unger S, et al. A retrospective analysis of the trends in acute appendicitis during the COVID-19 pandemic. J Laparoendosc Adv Surg Tech A. 2021; 31:243–246. PMID: 33181062.
Article
13. Willms AG, Oldhafer KJ, Conze S, Thasler WE, von Schassen C, Hauer T, et al. Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany. Langenbecks Arch Surg. 2021; 406:367–375. PMID: 33550453.
Article
14. Kim CW, Jeon SY, Paik B, Bong JW, Kim SH, Lee SH. Resident learning curve for laparoscopic appendectomy according to seniority. Ann Coloproctol. 2020; 36:163–171. PMID: 32054238.
Article
15. Fisher JC, Tomita SS, Ginsburg HB, Gordon A, Walker D, Kuenzler KA. Increase in pediatric perforated appendicitis in the New York City Metropolitan region at the epicenter of the COVID-19 outbreak. Ann Surg. 2021; 273:410–415. PMID: 32976285.
Article
16. Organisation for Economic Co-operation and Development (OECD). Health at a glance 2019: OECD indicators. Paris: OECD Publishing;2019.
17. Central Disease Control Headquarters. Coronavirus disease-19, Republic of Korea: global locations with COVID-19 [Internet]. Sejong, KR: Ministry of Health and Welfare;2021. cited 2021 Mar 14. Available from: http://ncov.mohw.go.kr.
18. Park Y, Huh IS, Lee J, Kang CR, Cho SI, Ham HJ, et al. Application of testing-tracing-treatment strategy in response to the COVID-19 outbreak in Seoul, Korea. J Korean Med Sci. 2020; 35:e396. PMID: 33230987.
Article
19. Kim M, Kim SJ, Cho HJ. Effect of surgical timing and outcomes for appendicitis severity. Ann Surg Treat Res. 2016; 91:85–89. PMID: 27478814.
Article
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