Management of acute appendicitis during the COVID-19 pandemic: A single tertiary center experience

Mor Aharoni*, Yiftach Barash, Yaniv Zager, Roi Anteby, Saed Khalilieh, Imri Amiel, Eyal Klang, Yuri Goldes, Mordechai Gutman, Nir Horesh, Danny Rosin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: The coronavirus disease-2019 (COVID-19) outbreak had an effect on healthcare. Objectives: To evaluate the presentation and management of patients with acute appendicitis. Methods: A retrospective study was conducted of all patients presenting with acute appendicitis to the emergency department of a large tertiary center during March and April 2020. Clinical features, diagnostic workup, and management were compared. Results: Seventy-four patients presented with acute appendicitis during the pandemic compared to 60 patients during the same time the year before. There were no significant differences in patient demographics: age (P = 0.65), gender (P = 0.73), smoking status (P = 0.48). During COVID-19 patients were more likely to complain of right lower quadrant pain (100% vs. 78.3%, P < 0.01). Rates of surgical treatment was similar (83.8% vs. 81.7%, P = 1); mean operative time was longer during COVID-19 (63 ± 23 vs. 52 ± 26 minutes, P = 0.03). There were no significant differences in intra-operative findings including the presence of appendiceal perforation (16.3% vs. 14.5%, P = 0.8), abscess (6.1% vs. 9.7%, P = 0.73), or involvement of cecum or terminal ileum (14.28% vs. 19.63%, P = 1). Postoperative treatment with antibiotics was more prevalent during COVID-19 (37.1% vs. 18%, P = 0.04). Length of stay (1.82 2.04 ± vs. 2.74 4.68 ±, P = 0.2) and readmission rates (6% vs. 11.3%, P =0.51) were similar. Conclusion: The COVID-19 pandemic did not significantly affect the presentation, clinical course, management, and outcomes of patients presenting with acute appendicitis.

Original languageEnglish
Pages (from-to)269-273
Number of pages5
JournalIsrael Medical Association Journal
Issue number5
StatePublished - May 2021


  • Appendectomy
  • Appendicitis
  • Coronavirus disease-2019 (COVID-19)
  • Pandemic
  • Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)


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