Conservative management of acute appendicitis in the era of COVID 19: A multicenter prospective observational study at the United Arab Emirates

Background & Aims: Since its emergence in December 2019, the COVID-19 pandemic resulted in a profound impact on the health care system worldwide. We propose herein to evaluate the impact of implementing conservative management as an alternative approach to surgical appendectomy during COVID19 pandemic. Materials and Methods: Our study is a prospective multicenter study that includes a cohort of 158 patients admitted to the surgical departments in both Tawam Hospital and SSMC hospital, Abu Dhabi, UAE, from February 2020 till July 2020. Results: Our results showed a significant decrease in length of hospital stay (LOS) (2.32 +/- 0.83 days) among conservatively treated group compared to the surgically treated group (2.8 +/- 1.47 days). Also, short term follow-up showed that 90% of those patients did not require further operative intervention or developed complications. Out of the 110 patients that were swapped for COVID19, nine (8.18%) were confirmed to be positive. Our protocol was to avoid surgical management for COVID19 positive patients unless indicated. This resulted in (8/9) of COVID19 positive patients to be treated conservatively. Conclusions: In conclusion, our results showed that the implementation of conservative management in treating patients with acute appendicitis who were COVID19 positive maybe essential in reducing viral transmission risks as well as avoiding operative risks on COVID19 positive patients. (C) 2021 The Author(s). Published by Elsevier Ltd on behalf of Surgical Associates Ltd.