Abstract
PurposeCOVID-19 pandemic had multiple influences on the social, industrial, and medical situation in all affected countries. Measures of obligatory medical confinement were suspensions of scheduled non-emergent surgical procedures and outpatients’ clinics as well as overall access restrictions to hospitals and medical practices. The aim of this retrospective study was to assess if the obligatory confinement (lockdown) had an effect on the number of appendectomies (during and after the period of lockdown).MethodsThis retrospective study was based on anonymized nationwide administrative claims data of the German Local General Sickness Fund (AOK). Patients admitted for diseases of the appendix (ICD-10: K35-K38) or abdominal and pelvic pain (ICD-10: R10) who underwent an appendectomy (OPS: 5-470) were included. The study period included 6 weeks of German lockdown (16 March–26 April 2020) as well as 6 weeks before (03 February–15 March 2020) and after (27 April–07 June 2020). These periods were compared to the respective one in 2018 and 2019.ResultsThe overall number of appendectomies was significantly reduced during the lockdown time in 2020 compared to that in 2018 and 2019. This decrease affects only appendectomies due to acute simple (ICD-10: K35.30, K35.8) and non-acute appendicitis (ICD-10: K36-K38, R10). Numbers for appendectomies in acute complex appendicitis remained unchanged. Female patients and in the age group 1–18 years showed the strongest decrease in number of cases.ConclusionThe lockdown in Germany resulted in a decreased number of appendectomies. This affected mainly appendectomies in simple acute and non-acute appendicitis, but not complicated acute appendicitis. The study gives no evidence that the confinement measures resulted in a deterioration of medical care for appendicitis.
Highlights
COVID-19 pandemic had multiple influences on the social, industrial, and medical situations in the affected countries
With respect to all patients, the periods before, during, and after the lockdown significantly differ in mean incidence per day, age, proportion of female sex, complex acute appendicitis (CAA), and nonacute appendicitis (NAA)
COVID-19 confinement measures were associated with a clear decline in the number of patients presenting to the emergency services for i.e. heart problems, bowel obstruction, and appendicitis [6]
Summary
COVID-19 pandemic had multiple influences on the social, industrial, and medical situations in the affected countries. Confinement measures to minimize the number of infected persons included social distancing, avoidance of contact, and formal lockdown in respective regions. Medical confinement measures had been introduced from 16 March 2020 in Germany, with suspension of all scheduled hospitalizations, elective operations, outpatients’ clinics, stoppage of screening measures (e.g., mammography), and reduced opening hours of practices. Main aspect of all measures was to avoid contacts in the medical setting and spare protective equipment. It had been assumed that COVID-19 pandemic would have had a major impact on the delivery of elective care and on emergency procedures. A recent report from Italy has shown a reduced rate of hospital admissions for acute coronary syndrome during COVID-19 outbreak [1]
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