Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown.

INTRODUCTION: In the spring of 2020, New York City was one of the first epicenters of the COVID outbreak. In this study, we evaluate the incidence and treatment of appendicitis in two New York City community hospitals during the COVID pandemic. METHODS: This retrospective study focused on the incidence and outcome of acute appendicitis in the adult population (>18 y old) during peak-COVID periods (March 16, 2020,-June 15, 2020) compared to pre-COVID and post-COVID periods. We compared the number of patients who underwent operative versus nonoperative management, patient demographics, length of stay (LOS), complications, and readmission rates within these time periods. Data are presented as mean ± standard deviation (analysis of variance). RESULTS: From January 1, 2020 to December 31, 2020, 393 patients presented with acute appendicitis and 321 (81.7%) were treated operatively, compared to 441 total and 366 treated operatively (83%) in 2019 (P = 0.88). During the COVID outbreak, fewer patients presented with appendicitis (mean 6.9 ± 1 pre-COVID case/week, 4.4 ± 2.4 peak-COVID cases/week and 7.6 ± 0.65 post-COVID cases/week, P = 0.018) with no significant difference in the pre-COVID and post-COVID period. There was no difference in LOS between the pre-, peak-, and post-COVID periods with a median of 1 for all the three, (interquartile range (IQR): 0.8-2, 0.6-2, 0.6-2, respectively, P = 0.43). Additionally, there was no difference in 30-day readmission rates (4.2%, 0%, 3.9%, P = 0.99) and postoperative complications (4.2%, 0%, 2.9%, P = 0.98). CONCLUSIONS: During peak-COVID, there was a significant reduction in the number of patients who presented with acute appendicitis without a post rebound increase in presentation. Those who presented during peak-COVID were able to undergo operative management safely, without affecting LOS or postoperative complications.

Operative Management of Acute Appendicitis is Safe During the COVID-19 Pandemic Shutdown

Background In the spring of 2020, New York City was one of the first epicenters of the COVID outbreak. In this study, we evaluate the incidence and treatment of appendicitis in two New York City community hospitals during the COVID pandemic. Methods This retrospective study focused on the incidence and outcome of acute appendicitis in the adult population (>18yo) during peak-COVID (3/16/20-6/15/20) compared to pre and post. We compared the number of patients who underwent operative vs non-operative management, patient demographics, length of stay (LOS), complications, and readmission rates within these time periods. Data is presented as mean ± SD (ANOVA). Results From 1/1/2020 to 12/31/2020, 393 patients presented with acute appendicitis and 321 (81.7%) were treated operatively, compared to 441 total and 366 treated operatively (83%) in 2019 (p=0.88). During the COVID outbreak, fewer patients presented with appendicitis (mean 6.9±1 pre-, 4.4±2.4 peak- and 7.6±0.65 post-COVID cases/week, p=0.018) with no significant difference pre and post. There was no difference in LOS between the pre, peak, and post periods with median of 1 for all three, (IQR 0.8-2, 0.6-2, 0.6-2 respectively p = 0.43). Additionally, there was no difference in 30-day readmission rates (4.2%, 0%, 3.9%, p=0.99) and post-operative complications (4.2%, 0%, 2.9%, p=0.98). Conclusion During peak-COVID, there was significant reduction in the number of patients who presented with acute appendicitis without a post-rebound increase in presentation. Those who presented during peak-COVID were able to undergo operative management safely, without affecting length of stay or post-operative complications.

SAGES 2022 guidelines regarding the use of laparoscopy in the era of COVID-19.

BACKGROUND: SARS-CoV-2 has changed global healthcare since the pandemic began in 2020. The safety of minimally invasive surgery (MIS) utilizing insufflation from the standpoint of safety to the operating room personnel is currently being explored. The aims of this guideline are to examine the existing evidence to provide guidance regarding MIS for the patient with, or suspecting of having, the SARS-CoV-2 as well as the healthcare team involved. METHODS: Systematic literature reviews were conducted for 2 key questions (KQ) regarding the safety of MIS in the setting of COVID-19 pandemic. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis criteria. Evidence-based recommendations were formulated using a narrative synthesis of the literature by subject experts. Recommendations for future research were also proposed. RESULTS: In KQ1, a total of 1361 articles were reviewed, with 2 articles meeting inclusion. In KQ2, a total of 977 articles were reviewed, with 4 articles met inclusions criteria, of which 2 studies reported on the SARS-CoV2 virus specifically. Despite many publications in the field, very little well-controlled and unbiased data exist to inform the recommendations. Of that which is available, it shows that both laparoscopic and open operations in Covid-positive patients had similar rates of OR staff positivity rates; however, patients who underwent laparoscopic procedures had a lower perioperative mortality than open procedures. Also, SARS-CoV-2 particles have been detected in the surgical plume at laparoscopy. CONCLUSION: With demonstrated equivalence of operating room staff exposure, and noninferiority of laparoscopic access with respect to mortality, either laparoscopic or open approaches to abdominal operations may be used in patients with SARS-CoV-2. Measures should be employed for all laparoscopic or open cases to prevent exposure of operating room staff to the surgical plume, as virus can be present in this plume.

Characterizing Pet Acquisition and Retention During the COVID-19 Pandemic.

In March 2020, Americans began experiencing numerous lifestyle changes due to the COVID-19 pandemic. Some reports have suggested that pet acquisition and ownership increased during this period, and some have suggested shelters and rescues will be overwhelmed once pandemic-related restrictions are lifted and lifestyles shift yet again. In May 2021, the ASPCA hired the global market research company Ipsos to conduct a general population survey that would provide a more comprehensive picture of pet ownership and acquisition during the pandemic. Although pet owners care for a number of species, the term pet owner in this study specifically refers to those who had dogs and/or cats. One goal of the survey was to determine whether data from a sample of adults residing in the United States would corroborate findings from national shelter databases indicating that animals were not being surrendered to shelters in large numbers. Furthermore, this survey gauged individuals' concerns related to the lifting of COVID-19 restrictions, and analyses examined factors associated with pet owners indicating they were considering rehoming an animal within the next 3 months. The data showed that pet ownership did not increase during the pandemic and that pets may have been rehomed in greater numbers than occurs during more stable times. Importantly, rehomed animals were placed with friends, family members, and neighbors more frequently than they were relinquished to animal shelters and rescues. Findings associated with those who rehomed an animal during the pandemic, or were considering rehoming, suggest that animal welfare organizations have opportunities to increase pet retention by providing resources regarding pet-friendly housing and affordable veterinary options and by helping pet owners strategize how to incorporate their animals into their post-pandemic lifestyles.

Perspectives on the Future Development of Mobile Applications for Dermatology Clinical Research.

The COVID-19 pandemic significantly impacted clinical research in dermatology and practices around the country transitioned to teledermatology amid physical distancing requirements. Despite their growing use in teledermatology and clinical care, dermatology applications have not been studied extensively in the research space. The use of mobile applications has the potential to improve the experience of study subjects and physicians and increase the pool of individuals willing to participate in research beyond the pandemic. We discuss the various pros and cons of mobile apps, as well as the necessary components they require to successfully conduct research.