Appendicitis Tends to Be Complicated During the COVID-19 Epidemic: A Multicentre Retrospective Study

Background: Past studies have found that social factors, such as restrictive measures and decreased willingness to seek care, have led to fewer visits and more complications in patients with acute appendicitis due to the prevalence of COVID-19. However, whether there is a clinical association between COVID-19 and acute appendicitis has not been reported. Methods: The effect of COVID-19 prevalence and associated factors on acute appendicitis in the control (2016-2019) and exposed (2020-2023) groups was derived from a retrospective study of 3070 patients with acute appendicitis from 2016 to 2023. Results: After the implementation of the restrictions, the rate of acute appendicitis visits in the exposed group compared to the control group dropped sharply in the initial period and recovered gradually as the restrictions were relaxed. Changes in the number of acute complex appendicitis visits were also consistent. After the restrictions were lifted and the COVID-19 outbreak occurred, there was a prolonged increase in the proportion of acute appendicitis complicated appendicitis in the exposed group compared with the control group, and some increase in the number of complicated appendicitis visits. In addition, the age profile of acute appendicitis during this period showed an aging trend. Conclusion: COVID-19 infections may be more likely to progress to complicated appendicitis after an episode of appendicitis, even if they have been cured for the same period of time. In addition, the proportion of elderly patients with appendicitis increased after the COVID-19 epidemic.