Background Currently, the world has been engulfed with the pandemicity of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and various mitigating measures like lock down and social distancing are being taken which have created significant impact in the emergency surgical health delivery including acute appendicitis (AA). The main aim of this study was to compare the demographic and clinical parameters between two cohorts before the onset of lockdown and within the pandemic.Methods A retrospective cohort analysis was performed between two groups of patients presenting with AA in one of the tertiary care centers of rural Nepal. The cohorts were named group A and group B who presented three months prior to and after initiation of lockdown on March 24 2020 respectively. These two groups of patients were compared in demographics, clinicopathological characteristics and surgical aspects of acute appendicitis. Results There were 42 patients in group A and 50 patients in group B. Mean age of the patients was 31.32±171.18 years with male preponderance in group B (N= 29). Mean duration of pain increased significantly in group B [55.4±25.9(B) vs 43.52±30.3(A) hours, P= 0.04] along with mean duration of surgery. [51.06±9.4(B) vs 45.27±11.8(A) minutes, P= 0.015] There was significant decrease in post-operative hospital stay among group B patients. [3.05±1.19(B) vs 4.05±0.8(A) days, P= 0.0001] Complicated cases increased in group B (38% vs 33.3 % including appendicular perforation in 10 cases with perforation rate of 20 %. Six of these 10 cohorts had fecalith present intraoperatively. (P= 0.0001) Similarly, mean duration of presentation to hospital significantly increased in group B patients with perforation. [64.8±22.7(B) vs 52.05±14.7(A) hours] Conclusion During the adversity of COVID 19, increased number of cases of AA can be dealt with surgery as the chances of late presentation and complexity of the lesion exists.

IntroductionThe world has been engulfed with the pandemicity of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which have created significant impact in the emergency surgical health delivery including acute appendicitis. The main aim of this study was to compare the demographic and clinical parameters between two cohorts before the onset of lockdown and within pandemic.MethodsA retrospective analysis was performed between two groups A and B, who presented with acute appendicitis three months prior to and after initiation of lockdown on March 24 2020 respectively in one of the tertiary centers of Nepal. These two cohorts were compared in demographics, clinicopathological characteristics and surgical aspects of acute appendicitis. ResultsThere were 42 patients in group A and 50 patients in group B. Mean age of the patient was 31.32±17.18 years with male preponderance in group B (N= 29). Mean duration of pain increased significantly in group B [57.8±25.9(B) vs 42.3±25.0(A) hours, P= 0.004] along with mean duration of surgery. [51.06±9.4(B) vs 45.27±11.8(A) minutes, P= 0.015] There was significant decrease in post-operative hospital stay among group B patients. [3.04±1.1(B) vs 3.86±0.67(A) days, P= 0.0001] Complicated cases increased in group B including appendicular perforation in 10 cases. Similarly, mean duration of presentation to hospital significantly increased in group B patients with perforation. [69.6±21.01 vs 51.57±17.63 hours, P= 0.008] ConclusionDuring the adversity of the current pandemic, increased number of cases of acute appendicitis can be dealt with surgery as the chances of late presentation and complexity of the lesion exists.