Changes in appendicitis treatment during the COVID-19 pandemic - A systematic review and meta-analysis.
Int J Surg
; 95: 106148, 2021 Nov.
Article
in English
| MEDLINE | ID: covidwho-1474631
ABSTRACT
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Appendicitis
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Adult
/
Child
/
Humans
Language:
English
Journal:
Int J Surg
Year:
2021
Document Type:
Article
Affiliation country:
J.ijsu.2021.106148
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