Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

This is a systematic review that was published in the International Journal of Surgery on October 23, 2021. During the COVID -19 pandemic many elective surgeries were postponed. In lieu of this, non-surgical interventions were recommended wherever possible. Instances of acute appendicitis and surgical intervention decreased during the pandemic. This paper sought to analyze the effect of non-surgical treatment on acute appendicitis. The researchers performed a systematic search of databases such as PubMed, Embase, and Cochrane. Of the initial 357 studies from their search results, 46 were deemed suitable. These were further divided and analyzed thru the following modalities. If there was overall change, if an open appendectomy was performed, if there was antibiotic treatment, the length of hospital stays, and the time it took present for the emergency room. Up to 34 articles focused on adults while 12 focused on children. During the pandemic there seemed to be a significant decrease in the incidence of appendicitis. Significantly more patients received antibiotic therapy than surgical intervention because practitioners were unlikely to intubate patients. Overall, IV antibiotic therapy spared surgical intervention but increased the need to stay in the hospital for longer periods of time. However, in cases where oral antibiotics were used, there was no burden on hospital bed capacity or length of stay. In conclusion, it seems that antibiotic treatment is therapeutic for cases of acute uncomplicated appendicitis.