Original Research Article
Year: 2020 | Month: September | Volume: 10 | Issue: 9 | Pages: 1-7
Acute Appendicitis During COVID-19: Changing Clinical Presentation And Outcome
Sathik1, S.Rajesh2, Deepan Karthick1, Rajmohan1, J.A. Jayalal3
1Assistant Professors, 2Postgraduate Resident, 3Professor,
Department of Surgery, Tirunelveli Medical College, Tamil Nadu.
Corresponding Author: J.A. Jayalal
ABSTRACT
Background: Acute Appendicitis is the most common surgical emergency. Worldwide Quarantine was advised by many countries during this pandemic period of COVID 19 to prevent mortality and disease dissemination. As the result even for acute conditions seeking medical consultations were delayed and ended with more complications.
Objectives: To compare the presentation of Acute Appendicitis before and during the COVID-19 pandemic, Grade of presentation of Acute Appendicitis before and during the COVID19, Postoperative complications before and during the COVID-19 pandemic.
Methodology: This is a retrospective observational study. Patients admitted in Tirunelveli medical college hospital, Department of General surgery with a clinical diagnosis of Acute Appendicitis for three months from January 2020 to March 2020(before the COVID -19 Pandemic) and April to June 2020(During the COVID-19 pandemic) were included in the study. Total there were 155 cases of appendicectomy done during this period.
They were classified according to the time of the appendicectomy, before the declaration of the state of alarm (non - COVID-19), and after its declaration in India, one the most affected countries in the world. An evaluation was made of demographic variables, type of appendicitis, hospital stay, and postoperative complications and outcome.
Results: A total of 155 Cases of Acute appendicitis was evaluated: 55 (32%) from the acute pandemic period and 105 (68%) from the non-pandemic period. No statistical difference in the male: female ratio and demographic pattern. But the high severity score for the appendicitis diagnosed in the pandemic period was 90% and for the same in the non COVID period was only 56% (p= .004) The number of cases reported in the hospital during the pandemic period is drastically reduced (P=.028), but the cases presented were with more advanced state of complication and had relatively more duration of hospital stay .71% of cases presented were had grade 1 and 2 diseases in the pre pandemic period and grade 3 and 4 cases in the pandemic period.
Conclusion: As the delay in visiting and seeking medical help, the disease progressed and as a result the outcome of therapeutic intervention is less positive. Hence adequate steps for hassle-free inflow of people in need of surgical care in this pandemic must be given priority and regulated.
Key words: Acute Appendicitis, SARS-CoV-2, COVID-19