Comparison of Clinical, Pathological, and Procedural Characteristics of Adult and Pediatric Acute Appendicitis before and during the COVID-19 Pandemic

Abstract

Aims: This study aims to examine the impact of the COVID-19 pandemic on the clinical, pathological, and surgical features of acute appendicitis (AA) in a tertiary referral center - Clinical Hospital Centre Zagreb, through a patient data comparison before and during the pandemic. Methods: Demographic (age, gender), clinical (duration of hospitalization), pathological (gangrenous AA, perforated AA, complications), and surgical data (type of appendectomy, negative appendectomy, conversion, revision) were retrospectively collected from an electronic database for all consecutive patients admitted for AA before and during the COVID-19 pandemic. Results: Demographic data were comparable between groups. There was statistically no significant difference in the type of appendectomy (p=0.331). The median hospital length of stay was 3 (2-5) days (p=0.078). There was an increase in the conversion rate (4.2% to 7.7%, p=0.031). The negative appendectomy rate did not differ significantly (5.6% vs. 4.2%, p=0.338). There was no significant difference in the incidence of perforated AA (13.3% vs. 15.7%, p=0.339). Conclusion: We did not observe a significant increase in the rate of AA complications during the COVID-19 pandemic at the Clinical Hospital Centre Zagreb. This could be because AA is typically diagnosed and treated in emergency care, which remained available during the pandemic. Additionally, diagnostic and therapeutic protocols remained unchanged despite the pandemic.