The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic.

Dear Editor,

I have been reading the article title “The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic” in the European Journal of Trauma and Emergency Surgery [1].

During the COVID-19 pandemic period, it was observed that there was a significant decrease in the rate of referral to hospitals [2]. It even led to reductions of up to 50% in emergency room volumes [3]. During the pandemic period, it was observed that fewer people applied to the emergency services, causing the diseases that these people applied to progress more [4]. In many studies, it is stated that admissions have increased due to complicated appendicitis [4, 5]. Finkelstein et al. stated that during the COVID-19 quarantine, there were more patients presenting with perforated appendicitis compared to the same period of the previous year, possibly due to observance of quarantine restrictions and fear of contracting COVID-19 in the hospital [6]. During the pandemic period, it has been reported that there is not only an increase in complicated appendicitis due to delay in hospital admissions for various reasons, but also an increase in the number of other surgical pathologies (such as cancer patients, cholecystitis etc.). Ceresoli et al. stated in their multicenter study that, unlike the literature, there was no change in the complicated appendicitis rates. How can we interpret this result?

Best regards