{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:25:45Z","timestamp":1789424745859,"version":"build-2803163510"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We investigated the impact of the COVID-19 pandemic on trends of presentation, management and pathology findings in patients who underwent an appendicectomy for suspected acute appendicitis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>The retrospective study reviewed patients (n = 939 adults and n = 329 children) who had an appendicectomy performed for suspected acute appendicitis and histopathology assessment in the Belfast Health and Social Care Trust, Northern Ireland. Pre-COVID-19 (March 2019 to February 2020) and COVID-19 Year 1 (March 2020 to February 2021) data were compared. Chi-squared tests were applied to compare timeframes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>513 adult appendicectomies were performed in the immediate year pre-COVID-19, compared to 426 in COVID-19 Year 1, representing a 17% reduction. No such reduction was seen within the paediatric population, likely related to a change in regional paediatric referral criteria during the pandemic. When comparing COVID-19 Year 1 with pre-pandemic, fewer patients presented with &lt;24 hours of symptoms (45% v 53%, p = 0.005), and there was greater use of pre-operative computed tomography imaging in adults (63.2% v 48.7%, p&lt;0.001). Fewer adult and paediatric cases of simple acute appendicitis and non-diagnostic specimens, with relative increased proportions of perforated acute appendicitis, were observed in COVID-19 Year 1 compared with pre-pandemic. No absolute increase in perforated acute appendicitis cases was observed in adults.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Year 1 of the COVID-19 pandemic was associated with delayed presentation of acute appendicitis in adults and children. In adults, an overall reduction in appendicectomy operations, increased use of pre-operative diagnostic imaging, and fewer specimens showing simple acute appendicitis or non-diagnostic features, collectively support appropriate restriction of surgery for those patients with a more certain acute appendicitis diagnosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0300357","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T17:46:21Z","timestamp":1713375981000},"page":"e0300357","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Impact of COVID-19 on acute appendicitis presentation, management and pathology findings in adult and paediatric populations"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-7386","authenticated-orcid":true,"given":"Dorothy B.","family":"Johnston","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen G.","family":"Coleman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Colvin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Lawther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice B.","family":"Loughrey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"pone.0300357.ref001","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","article-title":"Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines.","volume":"15","author":"S Di Saverio","year":"2020","journal-title":"World J Emerg Surg"},{"key":"pone.0300357.ref002","doi-asserted-by":"crossref","first-page":"j1703","DOI":"10.1136\/bmj.j1703","article-title":"Acute appendicitis.","volume":"357","author":"DLH Baird","year":"2017","journal-title":"BMJ"},{"key":"pone.0300357.ref003","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1097\/SLA.0000000000002188","article-title":"The global incidence of appendicitis: a systematic review of population-based studies","volume":"266","author":"M Ferris","year":"2017","journal-title":"Ann Surg"},{"key":"pone.0300357.ref004","first-page":"551","article-title":"Imaging of appendicitis in adults.","volume":"186","author":"M Karul","year":"2014","journal-title":"R\u00f6fo"},{"key":"pone.0300357.ref005","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1148\/radiol.2383050146","article-title":"MR imaging evaluation of acute appendicitis in pregnancy.","volume":"238","author":"I Pedrosa","year":"2006","journal-title":"Radiology"},{"key":"pone.0300357.ref006","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12876-015-0277-3","article-title":"Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systematic review of meta-analyses of randomised controlled trials.","volume":"15","author":"T Jaschinski","year":"2015","journal-title":"BMC Gastroenterol"},{"key":"pone.0300357.ref007","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.ijsu.2017.03.022","article-title":"Is laparoscopic appendectomy feasible for complicated appendicitis? 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