Managing acute appendicitis during the COVID-19 pandemic in Jiaxing, China

Zhou, Yuan; Cen, Lusha

doi:10.12998/wjcc.v8.i19.4349

Cited by 24 publications

(29 citation statements)

References 21 publications

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“…26 studies described a change in case number of appendicitis and/or appendectomies between comparable time periods before and during the COVID-19 pandemic in adults [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ]. Studies were conducted in 15 countries (as shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

Köhler

Müller

Hendricks

et al. 2021

International Journal of Surgery

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Background During the COVID-19 pandemic in 2020 a decrease of emergency consultations and modification in treatment of numerous medical conditions were observed. Aim of this paper was to evaluate the effect of the COVID-19 pandemic on incidence, treatment strategies, severity, length of hospital stay and time of presentation in adults and children with acute appendicitis. Methods A systematic literature search of Pubmed, Embase and Cochrane databases was performed, and eligible studies used to perform a meta-analysis. Results 46 suitable studies were identified with an overall reduction of appendicitis cases by 20.9% in adults and an increase of 13.4% in children. The rate of open appendectomies increased without statistical significance in both groups (adults: 8.5% vs. 7.1%, P = 0.32; children: 7.1% vs. 5.3%, P = 0.13), whereas the rate of antibiotic treatment increased significantly (P = 0.007; P = 0.03). Higher rates of complicated appendicitis were observed in adults (adults: OR 2.00, P < 0.0001; children: OR 1.64, P = 0.12). Time to first consultation did not change significantly (adults: 52.3 vs. 38.5 h – P = 0.057; children: 51.5 vs. 32.0 h – P = 0.062) and length of stay was also not lengthened during the pandemic (adults: 2.9 vs. 2.7 days, P = 0.057; children: 4.2 vs. 3.7 days, P = 0.062). Conclusion The COVID-19 pandemic of 2020 had major impact on incidence and treatment strategies of acute appendicitis. Results of this meta-analysis might be another hint to support the theory that appendicitis is not a progressive disease and surgeons can safely consider antibiotic therapy for acute uncomplicated appendicitis.

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Section: Resultsmentioning

confidence: 99%

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

Köhler

Müller

Hendricks

et al. 2021

International Journal of Surgery

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“…This systematic review included 14 studies [11][12][13][14][15][16][17][18][19][20][21][22][23][24] published in 2020. Five studies were based in the UK, three in USA, two in China, and one in Ireland, Nepal, Israel, and India.…”

Section: Study and Patients' Characteristicsmentioning

confidence: 99%

Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis

Emile

Hamid²,

Khan

et al. 2021

Journal of Gastrointestinal Surgery

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Background Non-operative management (NOM) of acute appendicitis has been assessed in several studies before COVID-19 pandemic. This systematic review aimed to assess the extent of adoption, efficacy, and safety of NOM of acute appendicitis in the setting of COVID-19. Methods This was a PRISMA-compliant systematic review of the literature. Electronic databases and Google Scholar were queried for studies that applied NOM of acute appendicitis during COVID-19. The main outcome measures were the rates of NOM application during the pandemic as compared to the pre-pandemic period, failure and complication rates of NOM. Failure was defined as the need for appendectomy during NOM and complications included development of appendicular mass or abscess. Results Fourteen studies (2140 patients) were included. The male to female ratio was 1.44:1 and median age was 34. Nine hundred fifty-nine (44.8%) patients had a trial of NOM. The weighted mean rate of NOM application was 50.1% (95%CI: 29.8–70.5%). The application of NOM during the pandemic was significantly more likely than its application before COVID-19 (OR = 6.7, p < 0.001). The weight mean failure rate of NOM was 16.4% (95%CI: 9.4–23.4). NOM failure was more likely in children and patients with complicated appendicitis. The weighted mean complication rate after NOM was 4.5% (95%CI: 1.4–7.7). NOM had significantly lower odds for complications than appendectomy (OR = 0.36, p = 0.03). There was no mortality after application of NOM. Conclusion NOM of acute appendicitis in the setting of COVID-19 may be a safe, short-term alternative to surgery with acceptably low failure and complication rates. Supplementary Information The online version contains supplementary material available at 10.1007/s11605-021-04988-1.

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“…Some recent publications have claimed that the number of complicated appendicitis cases has increased in adults during the pandemic (8,10,11). However, there are few publications about children.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 Pandemisi Çocuklarda Apandisit Tanısının Konulmasında Gecikmelere Neden Oluyor mu?

Demir¹,

Öztorun

Ertürk

et al. 2021

Turkish Journal of Pediatric Disease

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Objective: We aimed to investigate whether there is an increase in the number of complicated appendicitis during pandemic period. Material and Methods: Data of patients were evaluated retrospectively. Patients were divided into two-groups as pre-pandemic and pandemic. Age, gender, duration after the onset of complaints until visiting hospital, WBC count, days after presentation to hospital until surgery, surgical method, whether the appendix was complicated, duration of hospitalization, whether any complications developed, and results of PCR tests were evaluated. The data of the groups were compared and it was investigated whether there was any difference between them. Statistical analysis was done with the SPSS (Statistical Package for Social Sciences) version 21. P < 0.05 was considered significant. Results: Appendectomy was performed in 327 patients during pandemic and in 295 during pre-pandemic period. Although the ratio of complicated appendicitis increased during pandemic compared to pre-pandemic period (47.1% versus 40.7%), there was no difference between groups. However, duration between onset of symptoms and arrival at hospital (p=0.003), time elapsed before surgery (p=0.021), length-of-stay in hospital (p=0.009), and developed complications (p=0.01) were higher in pandemic group. Conclusion: Comparing prepandemic, although there was no statistically significant difference during the pandemic period, there was an increase in complicated appendicitis and related complications. It was attributed to late arrival at hospitals due to curfews, parental fear of disease transmission, and prolonged duration of screening tests in the emergency departments.

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Managing acute appendicitis during the COVID-19 pandemic in Jiaxing, China

Cited by 24 publications

References 21 publications

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis

COVID-19 Pandemisi Çocuklarda Apandisit Tanısının Konulmasında Gecikmelere Neden Oluyor mu?

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