Managing Appendicitis during Covid-19 National Lockdown Period: A Single Centre Experience

Abstract

Introduction: Covid-19  and related nationwide lockdown had a huge impact on the health care resources and services. The delay in the treatment due to  to lockdown may have effect on the managent of surgical emergency like acute appendicits. This study aims to find out  spectrum of presentation and possible complication of acute appendicitis seen during COVID-19 period  to emphasize the impact of COVID-19 pandemic to the disease burden.

Methods: A retrospective observational study was conducted at Department of Surgery, KIST Medical College and Teaching Hospital. Data was retrieved  from Health Management Information System (HMIS) records after approval from institutional review committee(IRC). Cases of acute appendicitis presenting to the hospital during lockdown from 24th March 2020 to 21st July 2020 ( Group 1) were compared with cases presented within similar period of time of previous year ;24th March 2019 to 21st July 2019 (Group 2).

Results:Demographic characteristics and Modified Alvarado Score  were similar among both groups. There was a statistically significant difference in duration of  presentation to hospital, 3.68±3.04days in Group 1 versus  2.49±1.56 days in Group 2. Increase in rate of complications (42% versus 19%, P=0.0222) was observed during lockdown. More patients were managed conservatively in Group 1. Average duration of admission to hospital was similar.

Conclusion: COVID-19 lockdown caused delay in the presentation of acute appendicitis cases which was associated with more complications.