The impact of COVID-19 pandemic on the treatment of acute appendicitis in China

Abstract

Objective This research aims to analyze the impact of the novel coronavirus pandemic on the hospital visits of patients with acute appendicitis. Methods The retrospective analysis was designed to look at the treatment of acute appendicitis in the Department of General Surgery in Beijing Jishuitan Hospital before and during the COVID-19 pandemic (2019–2020). Data was analyzed by the numbers of patients, sex, age, onset time, fever or not, laboratory examination, imaging test, and treatment. And we analyzed the differences between the “pre-COVID group” and “during-COVID group”. Results Compared with the year 2019, the number of acute appendicitis patients has diminished substantially during the COVID-19 pandemic (2020), but the number elevated with the control of the pandemic. Even if we did not find the differences of the treatment before and during the pandemic (P = 0.932), the onset time to emergency was significantly longer (P < 0.001), and more patients had showed fever (P < 0.001) during the COVID-19 pandemic. And the total number of white blood cells and C reactive protein level were significantly higher in 2020 than those in 2019 (P = 0.006, 0.003). And the same result was found in patients with appendiceal fecalith (P = 0.047). Conclusion During the pandemic of the new coronavirus pneumonia, the number of patients with acute appendix treatment dropped significantly, mainly because it took longer than before, and the condition was more severe. It can be seen that the new coronary pneumonia has a great impact on the patients’ medical treatment behavior, and the active prevention and treatment of the new coronavirus pneumonia is currently an important and urgent issue.

The Impact of the Coronavirus Disease - 19 Pandemic on the Clinical Characteristics and Treatment of Adult Patients with Acute Appendicitis

“…Similar to our findings, other studies have also reported a prolonged TSH in the pandemic era ( 18 , 23 ). Zheng et al ( 18 ) suggested that the reason for the delay in TSH was that patients were concerned about COVID-19 transmission at the hospital.…”

“…Similar to our findings, other studies have also reported a prolonged TSH in the pandemic era ( 18 , 23 ). Zheng et al ( 18 ) suggested that the reason for the delay in TSH was that patients were concerned about COVID-19 transmission at the hospital. Another study also explained that the reluctance to visit the ER was due to the government’s strong social distancing policy and patients’ fear of an in-hospital coronavirus infection ( 24 ).…”

“…In the UK, the antibiotic-first pathway has been accepted and implemented as the main treatment strategy for acute appendicitis in the era of the COVID-19 pandemic ( 17 ). Other changes associated with the management of appendicitis during the COVID-19 pandemic were also reported in several studies; the number of patients visiting the hospital for acute appendicitis decreased and the time from symptom onset to hospital arrival (TSH) increased, resulting in an increase in complicated cases ( 18 – 20 ). Further, the risk of complications such as perforation increased as the time from symptom onset to treatment became longer than 24 h ( 21 ).…”

Can Industrial Restructuring Improve Urban Air Quality?—A Quasi-Experiment in Beijing during the COVID-19 Pandemic

“…Previous literature on the relationship between industrial structure and environmental pollution is mainly based on OLS [49], threshold model [15], and SGVAR model [43], but they cannot solve the interference of missing variables, which will cause errors in the consistent estimation of parameters. It is always a difficult problem to effectively deal with the identification deviation caused by endogeneity.…”

Estimating the potential overdiagnosis and overtreatment of acute appendicitis in Thailand using a secondary data analysis of service utilization before, during and after the COVID-19 lockdown policy

“…During the COVID-19 pandemic, countries such as China, Egypt and Saudi Arabia observed an overall decrease in total number of patients with acute appendicitis alongside a concurrent increase in complications, such as gangrene or perforation [ 12 – 14 ]. We therefore hypothesise that diagnosis and treatment of cases during the pandemic was restricted to essential procedures only.…”