Effect of the pandemic on the presentation and management of patients with acute appendicitis at King Abdulaziz University Hospital in Saudi Arabia

Abstract

Background: The emergence of the coronavirus disease 2019 (COVID-19) pandemic led to significant changes in global healthcare systems, with a particular emphasis on prioritizing COVID-19 patients, even in emergency surgical scenarios. This study aimed to explore the impact of COVID-19 on the presentation and management of acute appendicitis cases in Saudi Arabia. Patients and Methods: This retrospective study was carried out at King Abdulaziz University Hospital (KAUH) from March 2019 to March 2021, encompassing all patients with appendicitis during this time frame. The data collected included demographic characteristics, clinical symptoms, laboratory findings, time taken before seeking medical help, diagnostic approaches, treatment strategies, postoperative complications, and hospital stay duration. Results: A total of 238 patients with acute appendicitis were hospitalized during the study, with a predominance of male patients (59.7%). Of these, 72.3% (174) were admitted during the pandemic period. Perforated appendicitis was diagnosed in 25 (10.5%) individuals. There were no significant differences observed between pre-and postpandemic periods concerning the time from presentation to surgery ( P=0.741 ), postoperative complications ( P=0.563 ), ICU admissions ( P=0.637 ), readmissions ( P=0.234 ), and overall length of hospital stay ( P=0.228 ). However, notable associations were noted in blood loss ( P<0.001 ) and postoperative length of stay ( P=0.021 ) between the two periods. Conclusion: Throughout the COVID-19 pandemic, there were no discernible differences in the duration from presentation to surgery, complications, ICU admissions, readmissions, and total length of hospital stay compared with the pre-pandemic period.