# Appendectomy: Cross-sectional study of the effects of COVID-19 in a hospital in South Brazil

## TL;DR

This study in Brazil found that appendectomies performed during the early pandemic did not have worse outcomes compared to before the pandemic.

## Contribution

First study in Brazil to evaluate appendectomy outcomes during the first year of the COVID-19 pandemic.

## Key findings

- No increased risk or worse outcomes for appendectomies during the first pandemic wave.
- Low SARS-CoV-2 infection rate among appendectomy patients.
- Anatomopathological findings showed no worse appendicitis progression during the pandemic.

## Abstract

COVID-19 has further burdened the Brazilian healthcare system, especially emergencies. Patients may have delayed seeking care for surgical abdominal pain. Delays in the approach may have impacted clinical evolution and outcomes. This study evaluated appendectomies and their complications performed by the public system during one-year follow-up of COVID-19 in a hospital in southern Brazil.

In this hospital-based cross-sectional study, we included adult patients who underwent appendectomy from March 2019 to April 2021 (n = 162). Patients were divided into pre-pandemic (n = 78) and pandemic (n = 84) groups based on the surgery date. The analyzed variables included hospitalization duration, intensive care unit (ICU) admission, surgical approach, histopathological findings, COVID-19 testing, patient outcomes, and 30-day survival rate.

The cohorts exhibited similar epidemiology, with the sex ratio and average age being maintained. No statistical difference was found in the 30-day survival rate and clinical outcomes. Of the four patients admitted to the ICU, three belonged to the pandemic cohort and tested negative for COVID-19. Only 47.6 % of the patients in the pandemic cohort underwent COVID-19 polymerase chain reaction examination; one tested positive (2.5 %).

This study demonstrated that there was no increased risk for appendectomies during the first wave of the pandemic. Surgeries were safe during this period. Patients continued to access the emergency service despite surgical abdominal pain and restrictive measures imposed by health authorities. The similar results observed across cohorts are attributed to the readiness of the teams and the availability of medical surgical equipment in safe quantities.

•First study in Brazil to evaluate appendectomy patients during one-year follow-up of the COVID-19 pandemic.•The pandemic did not affect clinical results of appendectomies, even with the overburdenet Brazilian healthcare system.•There was no increase in SARS-CoV-2 infection in patients indicated for appendectomy.•Anatomopathological analysis did not show worst degree of appendicitis evolution in the first year of the pandemic.

First study in Brazil to evaluate appendectomy patients during one-year follow-up of the COVID-19 pandemic.

The pandemic did not affect clinical results of appendectomies, even with the overburdenet Brazilian healthcare system.

There was no increase in SARS-CoV-2 infection in patients indicated for appendectomy.

Anatomopathological analysis did not show worst degree of appendicitis evolution in the first year of the pandemic.