Complicated Appendicitis in COVID-19 Era

Increased Incidence of Adult Complicated Appendicitis in One Resource-Competent Community During the Coronavirus Disease Pandemic: Time to Improve Health-Seeking Behaviors

Background The impact of the coronavirus disease 2019 (COVID-19) pandemic on medical services is overwhelming due to limited medical resources. During its initial surge in 2020, Taiwan's government rapidly established diverse public actions, which helped maintain the medical supply without travel restrictions. However, whether the fear of being infected with COVID-19 interfered with health-seeking behavior (HSB) remains unclear. Therefore, this study aimed to elucidate whether acute complicated appendicitis (ACA) rates in adults were affected by the COVID-19 pandemic.

Methods A retrospective analysis of acute appendicitis in adults was performed between January 1 and June 30, 2020 (COVID-19 period). The control period was collected from the first two quarters for the preceding 3 years. Outcome measures were ACA and length of hospital stays.

Study Overview

• Status: Completed
• Conditions: Covid19; Complicated Appendicitis
• Intervention / Treatment: Other: impact of COVID-19 on Health-Seeking Behaviors

• Study Type: Observational
• Enrollment (Actual): 465

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A retrospective analysis of acute appendicitis in adults was performed between January 1 and June 30, 2020 (COVID-19 period). The control period was collected from the first two quarters for the preceding 3 years. Outcome measures were ACA and length of hospital stays.

Description

Inclusion Criteria:

• Acute appendicitis

Exclusion Criteria:

• No

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Retrospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Complicated appendicitis; The development of complicated appendicitis, diagnosed during appendectomy or by pre-operative image study	Other: impact of COVID-19 on Health-Seeking Behaviors; The impact of the coronavirus disease 2019 (COVID-19) pandemic on medical services is overwhelming due to limited medical resources. During its initial surge in 2020, Taiwan's government rapidly established diverse public actions, which helped maintain the medical supply without travel restrictions. However, whether the fear of being infected with COVID-19 interfered with health-seeking behavior (HSB) remains unclear. Therefore, this study aimed to elucidate whether acute complicated appendicitis (ACA) rates in adults were affected by the COVID-19 pandemic.
Non-complicated appendicitis; No development of complicated appendicitis, diagnosed during appendectomy or by pre-operative image study	Other: impact of COVID-19 on Health-Seeking Behaviors; The impact of the coronavirus disease 2019 (COVID-19) pandemic on medical services is overwhelming due to limited medical resources. During its initial surge in 2020, Taiwan's government rapidly established diverse public actions, which helped maintain the medical supply without travel restrictions. However, whether the fear of being infected with COVID-19 interfered with health-seeking behavior (HSB) remains unclear. Therefore, this study aimed to elucidate whether acute complicated appendicitis (ACA) rates in adults were affected by the COVID-19 pandemic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of complicated appendicitis	The primary outcome measure was the occurrence of ACA defined as abscess observed in computed tomography, presence of appendiceal perforation determined by surgical documentation, or a description of gangrenous appendicitis assessed by pathological reports.	baseline, pre-surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of hospital stays	the duration of hospital stays after surgery	up to 4 weeks

Collaborators and Investigators

• Sponsor: National Taiwan University Hospital

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2017
• Primary Completion (Actual): June 30, 2020
• Study Completion (Actual): August 14, 2021

Study Registration Dates

• First Submitted: August 15, 2021
• First Submitted That Met QC Criteria: August 17, 2021
• First Posted (Actual): August 19, 2021

Study Record Updates

• Last Update Posted (Actual): August 19, 2021
• Last Update Submitted That Met QC Criteria: August 17, 2021
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Keywords: COVID-19; Health-seeking behavior; appendicitis
• Additional Relevant MeSH Terms: Digestive System Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; Gastrointestinal Diseases; Gastroenteritis; Intestinal Diseases; Cecal Diseases; Intraabdominal Infections; COVID-19; Appendicitis
• Other Study ID Numbers: 202008052RINC

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No