SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021
Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Spontaneous Resolution of Uncomplicated Appendicitis may Explain Increase in Proportion of Complicated Appendicitis During Covid-19 Pandemic: a Systematic Review and Meta-analysis.World journal of surgery · 2023Pooled it
- The Use of Mobile Applications for the Diagnosis and Treatment of Tumors in Orthopaedic Oncology - a Systematic Review.Journal of medical systems · 2021Pooled it
- Adaptation of emergency surgical care during successive COVID-19 waves: a single-center analysis of surgically treated acute appendicitis.BMC surgery · 2026Article
- Article
- Appendicitis.Nature reviews. Disease primers · 2025Review
- The Human Appendix and Antibiotics: Choice and Beneficence.ANZ journal of surgery · 2025Article
- Article
- Is non-operative treatment of acute appendicitis possible: A narrative review.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Review
- Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study.Archives of disease in childhood · 2024Article
- The impact of the COVID-19 pandemic on acute appendicitis patients in a tertiary care center in Lebanon.BMC surgery · 2024Observational
- Surgical aspects of pediatric abdominal pain in the era of COVID-19: clinical consideration and outcomes.Frontiers in pediatrics · 2024Article
- Impact of COVID-19 on acute appendicitis presentation, management and pathology findings in adult and paediatric populations.PloS one · 2024Article
- Clinical Characteristics of Acute Appendicitis in Pregnancy: 10-Year Experience at a Single Institution in South Korea.Journal of clinical medicine · 2023Article
- Patients with appendicitis during COVID-19 pandemic: a retrospective cohort study.Annals of medicine and surgery (2012) · 2023Article
- Impact of the Coronavirus (COVID-19) Pandemic on the Care of Pediatric Acute Appendicitis.The American surgeon · 2023Article
- Concurrent SARS-COV-19 and acute appendicitis: Management and outcomes across United States children's hospitals.Surgery · 2023Article
- Is it possible to predict the severity of acute appendicitis? Reliability of predictive models based on easily available blood variables.World journal of emergency surgery : WJES · 2023Article
- Impact of Covid-19 pandemic on volume and surgeon professional fees generated by emergency general surgery procedures.Surgical endoscopy · 2022Article
- Decision-making changes for patients and medical personnel in the management of acute appendicitis during the COVID-19 pandemic.BMC emergency medicine · 2022Article
- Effect of the COVID-19 pandemic on patients with presumed diagnosis of acute appendicitis.World journal of clinical cases · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-operative management (NOM) of acute appendicitis has been assessed in several studies before COVID-19 pandemic. This systematic review aimed to assess the extent of adoption, efficacy, and safety of NOM of acute appendicitis in the setting of COVID-19.
methodsThis was a PRISMA-compliant systematic review of the literature. Electronic databases and Google Scholar were queried for studies that applied NOM of acute appendicitis during COVID-19. The main outcome measures were the rates of NOM application during the pandemic as compared to the pre-pandemic period, failure and complication rates of NOM. Failure was defined as the need for appendectomy during NOM and complications included development of appendicular mass or abscess.
resultsFourteen studies (2140 patients) were included. The male to female ratio was 1.44:1 and median age was 34. Nine hundred fifty-nine (44.8%) patients had a trial of NOM. The weighted mean rate of NOM application was 50.1% (95%CI: 29.8-70.5%). The application of NOM during the pandemic was significantly more likely than its application before COVID-19 (OR = 6.7, p < 0.001). The weight mean failure rate of NOM was 16.4% (95%CI: 9.4-23.4). NOM failure was more likely in children and patients with complicated appendicitis. The weighted mean complication rate after NOM was 4.5% (95%CI: 1.4-7.7). NOM had significantly lower odds for complications than appendectomy (OR = 0.36, p = 0.03). There was no mortality after application of NOM.
conclusionNOM of acute appendicitis in the setting of COVID-19 may be a safe, short-term alternative to surgery with acceptably low failure and complication rates.
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