Presentation and outcomes of acute appendicitis during COVID-19 pandemic: lessons learned from the Middle East—a multicentre prospective cohort study

Ayman El Nakeeb,Sameh Hany Emile,Ahmed AbdelMawla,Mohamed Attia,Mohamed Alzahrani, Ayman ElGamdi, Abd elwahab Nouh, Abdulaziz Alshahrani, Riyadh AlAreef,Taha Kayed,Hosam Mohamad Hamza,Ahmad AlMalki,Fares Rayzah, Motaz Alsharif, Fares Alsharif,Mohammed M. Mohammed

International Journal of Colorectal Disease(2022)

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摘要
Background The coronavirus disease 2019 (COVID-19) pandemic had a striking impact on healthcare services in the world. The present study aimed to investigate the impact of the COVID-19 pandemic on the presentation management and outcomes of acute appendicitis (AA) in different centers in the Middle East. Methods This multicenter cohort study compared the presentation and outcomes of patients with AA who presented during the COVID-19 pandemic in comparison to patients who presented before the onset of the pandemic. Demographic data, clinical presentation, management strategy, and outcomes were prospectively collected and compared. Results Seven hundred seventy-one patients presented with AA during the COVID pandemic versus 1174 in the pre-COVID period. Delayed and complex presentation of AA was significantly more observed during the pandemic period. Seventy-six percent of patients underwent CT scanning to confirm the diagnosis of AA during the pandemic period, compared to 62.7% in the pre-COVID period. Non-operative management (NOM) was more frequently employed in the pandemic period. Postoperative complications were higher amid the pandemic as compared to before its onset . Reoperation and readmission rates were significantly higher in the COVID period, whereas the negative appendicectomy rate was significantly lower in the pandemic period ( p = 0.0001). Conclusion During the COVID-19 pandemic, a remarkable decrease in the number of patients with AA was seen along with a higher incidence of complex AA, greater use of CT scanning, and more application of NOM. The rates of postoperative complications, reoperation, and readmission were significantly higher during the COVID period.
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关键词
COVID-19, Pandemic, Appendicitis, Multicenter, Outcome
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