• Mor Aharoni, Yiftach Barash, Yaniv Zager, Roi Anteby, Saed Khalilieh, Imri Amiel, Eyal Klang, Yuri Goldes, Mordechai Gutman, Nir Horesh, and Danny Rosin.
• Department of Surgery and Transplantation B, Sheba Medical Center, Tel Hashomer, Israel.
• Isr Med Assoc J. 2021 May 1; 23 (5): 269-273.

BackgroundThe coronavirus disease-2019 (COVID-19) outbreak had an effect on healthcare.ObjectivesTo evaluate the presentation and management of patients with acute appendicitis.MethodsA retrospective study was conducted of all patients presenting with acute appendicitis to the emergency department of a large tertiary center during March and April 2020. Clinical features, diagnostic workup, and management were compared.ResultsSeventy-four patients presented with acute appendicitis during the pandemic compared to 60 patients during the same time the year before. There were no significant differences in patient demographics: age (P = 0.65), gender (P = 0.73), smoking status (P = 0.48). During COVID-19 patients were more likely to complain of right lower quadrant pain (100% vs. 78.3%, P < 0.01). Rates of surgical treatment was similar (83.8% vs. 81.7%, P = 1); mean operative time was longer during COVID-19 (63 ± 23 vs. 52 ± 26 minutes, P = 0.03). There were no significant differences in intra-operative findings including the presence of appendiceal perforation (16.3% vs. 14.5%, P = 0.8), abscess (6.1% vs. 9.7%, P = 0.73), or involvement of cecum or terminal ileum (14.28% vs. 19.63%, P = 1). Postoperative treatment with antibiotics was more prevalent during COVID-19 (37.1% vs. 18%, P = 0.04). Length of stay (1.82 ± 2.04 vs. 2.74 ± 4.68, P = 0.2) and readmission rates (6% vs. 11.3%, P =0.51) were similar.ConclusionsThe COVID-19 pandemic did not significantly affect the presentation, clinical course, management, and outcomes of patients presenting with acute appendicitis.

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