COVID-19 and Complicated Appendicitis: What is the Relationship?

Aims: The COVID-19 pandemic disrupted healthcare globally and several authors have observed a change in the presentation of acute appendicitis within the period. We have observed an upsurge in the presentation of complicated appendicitis within the first 4 weeks of 2021. We aim to compare our findings with a similar period prior to the COVID-19 pandemic.

Study design: Observational cohort study.

Place and duration of the study: Benue State University Teaching Hospital(BSUTH), Makurdi, Nigeria.

Methodology: We identified all patients that presented with appendicitis in our facility within the first four weeks of 2021 and retrieved their folders to ascertain our observation. We then retrieved the folders of patients who presented with appendicitis a year earlier when the pandemic was inexistent in our country. We compared the data between the two periods.

Results: In the period of the pandemic, we found an increased presentation of acute appendicitis, with most patients presenting as complicated appendicitis. There was an increased length of time between symptom onset and presentation, increase in operating time, postoperative complications, and length of hospital stay in the index period.

Conclusion: We conclude that there is an apparent increase in the presentation of complicated appendicitis with a resultant increase in post-operative complications and morbidity. However, these changes are likely a result of our response to the COVID-19 pandemic rather than the pathology of the SARS CoV-2 virus. We suggest that with the relaxation of movement restrictions and lockdowns in most places, and availability of COVID-19 vaccines, public enlightenment is necessary to encourage an early presentation of acute abdominal conditions with a view to decreasing morbidity.