Impact of the COVID-19 pandemic on the pattern of acute appendicitis, a single-center study

Background Acute appendicitis is a common surgical emergency. During the COVID-19 pandemic, a decline in emergency department visits for various conditions, including appendicitis, was noted. Objective To evaluate changes in the number, clinical presentation, and surgical approach of appendectomies performed during the COVID-19 lockdown compared to a pre-pandemic period. Design Retrospective cohort study. Patients All patients who underwent appendectomy for acute appendicitis during the lockdown months (March–May 2020 and 2021) were compared to those who had appendectomy during the same months in 2018–2019. Main outcome measures The rates of complicated (perforated) appendicitis, total number of procedures, and surgical modality (open vs. laparoscopic) were compared between the two periods. Results A total of 252 patients were included. During the pandemic period, 19.4% of patients presented with a perforated appendix vs. 9.3% in the pre-pandemic group ( p = 0.045, OR = 2.46). A significant decrease in the total number of appendectomies was observed during the pandemic ( p < 0.001). Additionally, the proportion of open appendectomies increased during the lockdown. Conclusion In our study, the COVID-19 lockdown was associated with a significant increase in the rate of perforated appendicitis, a reduction in hospital-treated cases, and a higher rate of open surgery. These findings may suggest delayed patient presentation during the pandemic or a relative decrease in less severe cases.