Impact of COVID-19 pandemic on acute appendicitis presentation: A retrospective two-center study in Saudi Arabia

Objectives: This research aimed to compare the incidence and severity of acute appendicitis (AA) before and during the COVID-19 pandemic. Materials and Methods: Two southern Saudi Arabian high-volume hospitals hosted this retrospective investigation. The COVID pandemic period (March–June 2020) and the pre-COVID period were identified (March–June 2019). The frequency, clinical manifestation, and severity of AA were compared for patients who underwent appendectomies during these periods. Results: In the study hospitals, total admissions decreased by 52.3% (95% confidence interval [CI]: 51.1%–53.3%) from 6231 patients during the pre-COVID period to 3261 patients during the COVID period. In the 2019 study period, 107 cases of AA were surgically treated, compared to 61 cases in 2020. The observed reduction rate was 57.1% (95% CI: 47.5%–66.8%). During the COVID period, the duration from the onset of symptoms to hospital admission and hospital admission to surgery was significantly shorter for patients. There were no significant differences between the COVID and pre-COVID periods in terms of the clinical picture or severity of AA. Conclusions: During the COVID era, there was a significant decrease in the number of AA patients hospitalized, which may indicate the efficacy of home treatment for mild cases. The successful measures taken by the Saudi Arabian government during the curfew, along with the optimal utilization of resources and logistics, resulted in the early presentation and management of AA, yielding results comparable to the pre-COVID era.