ArticleTechniques in coloproctology2021
The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study.
Article in Techniques in coloproctology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04707339 (Management of Acute Appendicitis at District General Hospital), which is not on this map. Cited by 55 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Management of Acute Appendicitis at District General Hospital
Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- SAGES guidelines update to laparoscopy in the era of COVID-19.Surgical endoscopy · 2025Guideline
- Randomized clinical trials comparing antibiotic therapy with appendicectomy for uncomplicated acute appendicitis: meta-analysis.BJS open · 2022Pooled it
- Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Pooled it
- The impact of COVID-19 on surgical training: a systematic review.Techniques in coloproctology · 2021Pooled it
- Viral load of SARS-CoV-2 in surgical smoke in minimally invasive and open surgery: a single-center prospective clinical trial.Scientific reports · 2023Trial
- CONservative TReatment of Appendicitis in Children: a randomised controlled feasibility Trial (CONTRACT).Archives of disease in childhood · 2021Trial
- COVID-19-specific risk factor for early post-appendectomy complications (EPAC) in older patients: a retrospective study.Techniques in coloproctology · 2025Observational
- Appendicolith appendicitis: should we be operating sooner? A retrospective cohort study.Annals of the Royal College of Surgeons of England · 2024Article
- Two-year outcomes of conservatively managed appendicitis during the COVID-19 pandemic-a multicentre cohort study.Langenbeck's archives of surgery · 2023Observational
- The reorganisation of emergency general surgery services during the COVID-19 pandemic in the UK: outcomes of delayed presentation, socio-economic deprivation and Black, Asian and Minority Ethnic patients.Annals of the Royal College of Surgeons of England · 2023Article
- One-year follow-up of conservative management of appendicitis: results from a single centre during extended lockdown in the COVID-19 pandemic.Annals of the Royal College of Surgeons of England · 2023Article
- Management of acute appendicitis during COVID-19 pandemic. Single center data from a tertiary care hospital in Germany.Innovative surgical sciences · 2023Article
- Management of Acute Appendicitis During the COVID-19 Pandemic: A Single-Centre Retrospective Cohort Study.Cureus · 2023Article
- Management of appendicitis: appendicectomy, antibiotic therapy, or both?Annals of medicine and surgery (2012) · 2023Article
- Concurrent SARS-COV-19 and acute appendicitis: Management and outcomes across United States children's hospitals.Surgery · 2023Article
- Routine ultrasound for suspected appendicitis in children: a single-centre retrospective cohort study.Annals of the Royal College of Surgeons of England · 2023Article
- Impact of COVID-19 pandemic on surgical residency: Residents' perception.Journal of education and health promotion · 2023Article
- Acute appendicitis during coronavirus disease 2019 in Türkiye: Changes in clinical approach, treatment, and diagnosis modalities: A retrospective and cohort study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2022Article
- The Efficacy of Conservative Management in Uncomplicated Acute Appendicitis - A Single-Center Retrospective Study.Cureus · 2022Article
- Impact of Covid-19 pandemic on volume and surgeon professional fees generated by emergency general surgery procedures.Surgical endoscopy · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute appendicitis (AA) is the most common general surgical emergency. Early laparoscopic appendicectomy is the gold-standard management. SARS-CoV-2 (COVID-19) brought concerns of increased perioperative mortality and spread of infection during aerosol generating procedures: as a consequence, conservative management was advised, and open appendicectomy recommended when surgery was unavoidable. This study describes the impact of the first weeks of the pandemic on the management of AA in the United Kingdom (UK).
methodsPatients 18 years or older, diagnosed clinically and/or radiologically with AA were eligible for inclusion in this prospective, multicentre cohort study. Data was collected from 23rd March 2020 (beginning of the UK Government lockdown) to 1st May 2020 and included: patient demographics, COVID status; initial management (operative and conservative); length of stay; and 30-day complications. Analysis was performed on the first 500 cases with 30-day follow-up.
resultsThe patient cohort consisted of 500 patients from 48 sites. The median age of this cohort was 35 [26-49.75] years and 233 (47%) of patients were female. Two hundred and seventy-one (54%) patients were initially treated conservatively; with only 26 (10%) cases progressing to an operation. Operative interventions were performed laparoscopically in 44% (93/211). Median length of hospital stay was significantly reduced in the conservatively managed group (2 [IQR 1-4] days vs. 3 [2-4], p < 0.001). At 30 days, complications were significantly higher in the operative group (p < 0.001), with no deaths in any group. Of the 159 (32%) patients tested for COVID-19 on admission, only 6 (4%) were positive.
conclusionCOVID-19 has changed the management of acute appendicitis in the UK, with non-operative management shown to be safe and effective in the short-term. Antibiotics should be considered as the first line during the pandemic and perhaps beyond.
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