Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.859
Peer-review started: April 1, 2021
First decision: May 13, 2021
Revised: May 31, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: August 27, 2021
The ongoing coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted both elective and acute medical care. Data from the early months suggest that acute care patient populations deferred presenting to the emergency department (ED), portending more severe disease at the time of presentation. Additionally, care for this patient population trended towards initial non-ope
To examine the presentation, management, and outcomes of patients who deve
A retrospective chart review of patients diagnosed with acute cholecystitis, symptomatic cholelithiasis, or appendicitis in two EDs affiliated with a single tertiary academic medical center in Northern California between March and June, 2020 and in the same months of 2019. Patients were selected through a research repository using international classification of diseases (ICD)-9 and ICD-10 codes. Across both years, 313 patients were identified with either type of gallbladder disease, while 361 patients were identified with acute appendicitis. The primary outcome was overall incidence of disease. Secondary outcomes included pre
Patients with gallbladder disease and appendicitis both had more severe presentations in 2020. With respect to gallbladder disease, more patients in the COVID-19 cohort presented with acute cholecystitis compared to the control cohort [50% (80) vs 35% (53); P = 0.01]. Patients also presented with more severe cholecystitis in 2020 as indicated by higher mean Tokyo Criteria Scores [mean (SD) 1.39 (0.56) vs 1.16 (0.44); P = 0.02]. With respect to appendicitis, more patients were diagnosed with a perforated appendix at presentation in 2020 [20% (36) vs 16% (29); P = 0.02] and a greater percentage were classified as emergent cases using the emergency severity index [63% (112) vs 13% (23); P < 0.001]. While a greater percentage of patients were admitted to the hospital for gallbladder disease in 2020 [65% (104) vs 50% (76); P = 0.02], no significant differences were observed in hospital admissions for patients with appendicitis. No significant differences were ob
During the COVID-19 pandemic, patients presented with more severe gallbladder disease and appendicitis. These findings suggest that the pandemic has affected patients with acute surgical conditions.
Core Tip: The coronavirus disease 2019 (COVID-19) pandemic has impacted patients with a wide range of diseases due to stay-at-home orders and concerns surrounding the safety and feasibility of accessing care. This study demonstrates that the pandemic resulted in more severe presentations of gallbladder disease and appendicitis, which may be related to delays prior to presentation. Additionally, the pandemic influenced the management of patients with acute surgical conditions, and affected outcomes for patients with acute appendicitis. These findings can inform policy and public messa