Impact of coronavirus disease 2019 (COVID-19) on acute appendicitis in Hong Kong: Retrospective cohort study in a local cluster hospital

Background: Coronavirus disease 2019 (COVID-19) impacted Hong Kong in early January 2020. Quarantine and social distancing measures have been implemented to prevent disease spread. Material and Method: Retrospective cohort study was carried out in our cluster to compare the acute appendicitis cases during pandemic period, January 1, 2020 to June 30, 2020, with the same period 1 year before. Parameters including time of presentation, complicated appendicitis rate, operative time, post-operative complication rate, and total length of stay were compared and analysed. Results: A total number of 348 patients (160 in the pre-COVID group versus 188 in the post-COVID group) were included. There is no significant difference in basic demographics. The time of presentation was significantly longer in March (3.75 days vs 1.56 days, P = .031) and June 2020 (3.02 days vs 1.88 days, P = .026) compared with the pre-COVID group, which correlate with the spike of local confirmed cases. There was a significantly higher incidence of complicated appendicitis (67% vs 52%, P = .028) and post-operative complication rate (29% vs 7%, P = .042) in February post-COVID group compare with the pre-COVID group. Conclusion: During the COVID-19 pandemic period, more patients with acute appendicitis presented late to the hospital, with an increase in complicated appendicitis rate and post-operative complication rate.