European Journal of Molecular & Clinical Medicine

Abstract

Background: Acute appendicitis (AA) is the most common surgical disease with a lifetime risk
of 7–8%.Traditionally, appendectomy has been the treatment of choice for acute appendicitis.
Mortality rate after appendectomy is very low and may range from 0.07 to 0.7% rising to 0.5 to
2.4% in patients without and with perforation. Over 250,000 appendectomies are performed each
year in the USA alone.It was observed during the outbreaks of influenza and Middle East
Respiratory Syndrome (MERS) in 2012 , that referrals for non-respiratory causes decreased
significantly as the epidemics progressed. An outbreak of respiratory disease should not by itself
affect the incidence and presentation of acute appendicitis. Nevertheless, we have noticed in our
institution that as the COVID-19 pandemic spread in our community there was a significant
decrease in the number of cases of acute appendicitis presenting to the ED of our institution and
an increase in the number of admitted patients of AA requiring surgery.
Objectives: To compare the incidence and presentation of aute appendicitis before and during
the COVID-19 lockdown period.Also, to compare thepercentage of patients requiring operative
management, intraoperative findings and postoperative complications before and during the
COVID-19 pandemic for cases of acute appendicitis.
Methodology:This prospective observational cohort study was undertaken at Government
Medical College Baramulla which is a 300 bedded teaching hospital catering as a referral
institute for a catchment population of roughly 1.2 million. All consecutive patients of clinically
or radiologically diagnosed AA admitted between 25th March and 25th July were included in
this study (corresponding to complete lockdown in our country). This was designated as group
A. Data was also collected from hospital records of all acute appendicitis patients admitted in the
corresponding months of 2019 i.e from 25th March 2019 to 25th July 2019 and analysed for
comparison and designated as group B