2021-05-23

Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.; Department of Surgery, Noordwest Hospital Group, Alkmaar, the Netherlands.; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.; Department of Surgery, Isala Hospital, Zwolle, the Netherlands.; Department of Surgery, Hospital Group Twente, Almelo, the Netherlands.; Department of Surgery, OLVG, Amsterdam, the Netherlands.; Department of Surgery, Haaglanden Medical Center, The Hague, the Netherlands.; Departement of Surgery, Flevo Hospital, Almere, the Netherlands.; Department of Surgery, Maasstad Hospital, Rotterdam, the Netherlands.; Department of Surgery, Gelre Hospitals, Apeldoorn, the Netherlands.; Department of Surgery, Tergooi Hospitals, Hilversum, the Netherlands.; Department of Surgery, OLVG, Amsterdam, the Netherlands.; Department of Surgery, Elisabeth - Tweesteden Hospital, Tilburg, the Netherlands.; Department of Surgery, Zuyderland Medical Center, Sittard-Geleen/Heerlen, the Netherlands.; Department of Surgery, Amphia Hospital, Breda, the Netherlands.; Department of Surgery, Maastricht UMC+, Maastricht, the Netherlands.; Department of Surgery, Dijklander Hospital, Hoorn, the Netherlands.; Department of Surgery, VieCuri Medisch Centrum for Noord-Limburg, Venlo, the Netherlands.; Department of Emergency Medicine, St Jansdal Hospital, Harderwijk, the Netherlands.; Department of Surgery, Sint Antonius Hospital, Nieuwegein, the Netherlands.; Department of Surgery, Rijnstate Hospital, Arnhem, the Netherlands.; Department of Surgery, Spaarne Gasthuis, Haarlem, and Hoofddorp, the Netherlands.; Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Radiology and Nuclear Medicine, Maastricht UMC+, Maastricht, the Netherlands.; Department of Radiology and Nuclear Medicine, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.; Department of Surgery, Amsterdam UMC, location AMC, Amstserdam Gastroenterology Endocrinology Metabolism, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. m.a.boermeester@amsterdamumc.nl.CN - SCOUT Collaboarative Study group

BACKGROUND: During the COVID-19 pandemic, a decrease in the number of patients presenting with acute appendicitis was observed. It is unclear whether this caused a shift towards more complicated cases of acute appendicitis. We compared a cohort of patients diagnosed with acute appendicitis during the 2020 COVID-19 pandemic with a 2019 control cohort. METHODS: We retrospectively included consecutive adult patients in 21 hospitals presenting with acute appendicitis in a COVID-19 pandemic cohort (March 15 - April 30, 2020) and a control cohort (March 15 - April 30, 2019). Primary outcome was the proportion of complicated appendicitis. Secondary outcomes included prehospital delay, appendicitis severity, and postoperative complication rates. RESULTS: The COVID-19 pandemic cohort comprised 607 patients vs. 642 patients in the control cohort. During the COVID-19 pandemic, a higher proportion of complicated appendicitis was seen (46.9% vs. 38.5%; p = 0.003). More patients had symptoms