AimsTo evaluate the impact of CV19 on surgical technique and patient outcome in management of acute appendicitis during the 1st wave.MethodData was collected on patients presenting with appendicitis to ED. Group A: Jan-March 2020, pre COVID and Group B: April-June 2020: peri COVIDResultsThere was no difference in sex, age and length of stay between groups. In group A [n = 194], 88% had lap appendicectomy vs Group B [n = 98], 97% had an open operation. Group A had a complication rate of 6% [wound infection] with no readmissions. Group B had 31% complication rate [intra-abdominal collection, bleeding, and ileus] requiring readmission.685 surgical patients attended ED in the first half of 2020 of which 4 % had an appendicectomy. However the method of surgical access in the 1st wave significantly impacted on patient outcome, resource and re-admission rates.ConclusionIn our study open appendicectomy undertaken due to concerns around COVID transmission during laparoscopic surgery during the 1st wave, increased rates of complications and readmission thus raising hospital costs and chances of COVID 19 infection in these patients.As a result of this and due to greater confidence in laparoscopic surgery as a whole we have returned to undertaking laparoscopic appendicectomy in the current wave. Further analysis is underway assessing the impact of COVID on all emergency operations undertaken in the 1st wave.