Differences in the evolution and management of acute appendicitis in patients with COVID-19: a case–control study

Abstract

Background: The COVID-19 pandemic has generated uncertainty about the management of appendicitis. Aim: The aim of this study was to evaluate differences in the evolution and treatment of acute appendicitis in patients with COVID-19 infection compared to patients without the infection. Methods: A case–control study of adult patients hospitalized for acute appendicitis was performed, having as cases those who presented COVID-19. Data were extracted from the medical records. The logistic regression model was used to calculate crude (cOR) and adjusted odds ratios (aOR) with their respective 95% confidence intervals (95% CI). Results: We evaluated 38 cases and 76 controls, the mean age of the patients was 38.2 years (± 16.8), of whom 55.3% were women. Multivariate analysis showed, in cases, a lower probability of intraoperative findings (aOR: 0.21; 95% CI: 0.05-0.90) and a surgery time of more than 60 min (aOR: 0.21; 95% CI: 0.06-0.80), while there was a greater probability of management by open surgery (aOR: 3.83; 95% CI: 1.42-10.32) and a hospitalization time of more than 3 days after surgery (aOR: 3.33; 95% CI: 1.34-8.26). Conclusion: Significant differences were observed in terms of intraoperative findings, type of surgery, intraoperative time, and hospitalization time in patients with acute appendicitis and COVID-19.