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Impact of the COVID-19 pandemic on incidence and severity of acute appendicitis: a comparison between 2019 and 2020.
Scheijmans, Jochem C G; Borgstein, Alexander B J; Puylaert, Carl A J; Bom, Wouter J; Bachiri, Said; van Bodegraven, Eduard A; Brandsma, Amarins T A; Ter Brugge, Floor M; de Castro, Steve M M; Couvreur, Roy; Franken, Lotte C; Gaspersz, Marcia P; de Graaff, Michelle R; Groenen, Hannah; Kleipool, Suzanne C; Kuypers, Toon J L; Martens, Milou H; Mens, David M; Orsini, Ricardo G; Reneerkens, Nando J M M; Schok, Thomas; Sedee, Wouter J A; Tavakoli Rad, Shahzad; Volders, José H; Weeder, Pepijn D; Prins, Jan M; Gietema, Hester A; Stoker, Jaap; Gisbertz, Suzanne S; Besselink, Marc G H; Boermeester, Marja A.
  • Scheijmans JCG; Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
  • Borgstein ABJ; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Puylaert CAJ; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Bom WJ; Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
  • Bachiri S; Department of Surgery, Noordwest Hospital Group, Alkmaar, the Netherlands.
  • van Bodegraven EA; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
  • Brandsma ATA; Department of Surgery, Isala Hospital, Zwolle, the Netherlands.
  • Ter Brugge FM; Department of Surgery, Hospital Group Twente, Almelo, the Netherlands.
  • de Castro SMM; Department of Surgery, OLVG, Amsterdam, the Netherlands.
  • Couvreur R; Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands.
  • Franken LC; Departement of Surgery, Flevo Hospital, Almere, the Netherlands.
  • Gaspersz MP; Department of Surgery, Maasstad Hospital, Rotterdam, the Netherlands.
  • de Graaff MR; Department of Surgery, Gelre Hospitals, Apeldoorn, the Netherlands.
  • Groenen H; Department of Surgery, Tergooi Hospitals, Hilversum, the Netherlands.
  • Kleipool SC; Department of Surgery, OLVG, Amsterdam, the Netherlands.
  • Kuypers TJL; Department of Surgery, Elisabeth - Tweesteden Hospital, Tilburg, the Netherlands.
  • Martens MH; Department of Surgery, Zuyderland Medical Center, Sittard-Geleen/Heerlen, the Netherlands.
  • Mens DM; Department of Surgery, Amphia Hospital, Breda, the Netherlands.
  • Orsini RG; Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands.
  • Reneerkens NJMM; Department of Surgery, Dijklander Hospital, Hoorn, the Netherlands.
  • Schok T; Department of Surgery, VieCuri Medisch Centrum for Noord-Limburg, Venlo, the Netherlands.
  • Sedee WJA; Department of Emergency Medicine, St Jansdal Hospital, Harderwijk, the Netherlands.
  • Tavakoli Rad S; Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands.
  • Volders JH; Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.
  • Weeder PD; Department of Surgery, Spaarne Gasthuis, Haarlem, and Hoofddorp, the Netherlands.
  • Prins JM; Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Gietema HA; Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, the Netherlands.
  • Stoker J; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Gisbertz SS; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Besselink MGH; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Boermeester MA; Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. m.a.boermeester@amsterdamumc.nl.
BMC Emerg Med ; 21(1): 61, 2021 05 12.
Article in English | MEDLINE | ID: covidwho-1225758
ABSTRACT

BACKGROUND:

During the COVID-19 pandemic, a decrease in the number of patients presenting with acute appendicitis was observed. It is unclear whether this caused a shift towards more complicated cases of acute appendicitis. We compared a cohort of patients diagnosed with acute appendicitis during the 2020 COVID-19 pandemic with a 2019 control cohort.

METHODS:

We retrospectively included consecutive adult patients in 21 hospitals presenting with acute appendicitis in a COVID-19 pandemic cohort (March 15 - April 30, 2020) and a control cohort (March 15 - April 30, 2019). Primary outcome was the proportion of complicated appendicitis. Secondary outcomes included prehospital delay, appendicitis severity, and postoperative complication rates.

RESULTS:

The COVID-19 pandemic cohort comprised 607 patients vs. 642 patients in the control cohort. During the COVID-19 pandemic, a higher proportion of complicated appendicitis was seen (46.9% vs. 38.5%; p = 0.003). More patients had symptoms exceeding 24 h (61.1% vs. 56.2%, respectively, p = 0.048). After correction for prehospital delay, presentation during the first wave of the COVID-19 pandemic was still associated with a higher rate of complicated appendicitis. Patients presenting > 24 h after onset of symptoms during the COVID-19 pandemic were older (median 45 vs. 37 years; p = 0.001) and had more postoperative complications (15.3% vs. 6.7%; p = 0.002).

CONCLUSIONS:

Although the incidence of acute appendicitis was slightly lower during the first wave of the 2020 COVID-19 pandemic, more patients presented with a delay and with complicated appendicitis than in a corresponding period in 2019. Spontaneous resolution of mild appendicitis may have contributed to the increased proportion of patients with complicated appendicitis. Late presenting patients were older and experienced more postoperative complications compared to the control cohort.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Emerg Med Journal subject: Emergency Medicine Year: 2021 Document Type: Article Affiliation country: S12873-021-00454-y

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: BMC Emerg Med Journal subject: Emergency Medicine Year: 2021 Document Type: Article Affiliation country: S12873-021-00454-y