Institutional Repository

Introduction: COVID-19 pandemic has generated changes regarding presentation and management of surgical pathologies. Therefore, the aim of this study was to analyze the clinical course and surgical outcomes of acute appendicitis (AA) in pre-pandemic and pandemic periods. Methods: Multicenter observational cohort study. Patients from two reference hospitals diagnosed with AA who underwent surgical management were analyzed in two different time periods. Pre-COVID-19 vs COVID-19 period (March 2019 - January 2020 vs March 2020 - January 2022). Results: A total of 1468 patients were included. 759 pre-covid (PC) and 709 covid period (CP), mainly female (51.84 %, n = 761). Open approach was preferred in 90.1% of the cases. Both groups were similar in terms of mean age (37.87±0.61 PC vs 38.3 ±0.64 CP), mean weight (69.32 ± 0.28 PC vs 68.87 ±0.32 CP) and duration of symptoms (39.15 ± 1.17 PC vs 40.66± 1.99 CP group). Significant differences were identified in mortality (0.28% PC vs 1.28% CP, p 0,04), in-hospital stay mean (2.76±0.13 PC vs 3.12±0.11 CP, p 0,007) and localized peritonitis (10.29% PC vs 14.36% CP, p 0,003). Multivariate analysis showed that patient with AA during COVID19 period has a higher mortality risk (RR 4.02 CI95% 1.75-5.76), and increased in-hospital stay (RR 1.91 CI95% 1.2-2.6) and higher severity according to intraoperative classification (RR 4.54 CI95% 4.01-5.21). Conclusion: SARS-COV 2 pandemic seems to negatively impact AA outcomes with an increased mortality risk by almost 4 times, larger in-hospital stay and intraoperative higher complex severity grade.