Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/120535
Title: Surgical management of acute appendicitis during the European COVID-19 second wave: safe and effective
Authors: Forssten, MP
Kaplan, LJ
Tolonen, M
Martinez-Casas, I
Cao, Y
Walsh, TN
Bass, GA
Mohseni, S
Rahy Martín, Aída Cristina 
UNESCO Clasification: 32 Ciencias médicas
3213 Cirugía
320505 Enfermedades infecciosas
Keywords: Acute appendicitis
COVID-19
Observational cohort
Appendectomy
Outcomes
Issue Date: 2023
Journal: European Journal of Trauma and Emergency Surgery 
Abstract: Introduction: The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy. Methods: Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged ≥ 15 years who underwent appendectomy for appendicitis (November 2020–May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model. Results: Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications. Conclusion: During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.
URI: http://hdl.handle.net/10553/120535
ISSN: 1863-9933
DOI: 10.1007/s00068-022-02149-w
Source: European Journal of Trauma and Emergency Surgery [1863-9933] , v. 49(1), pp.57-67 (Febrero 2023)
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