Background: Non-operative management (NOM) of acute appendicitis has regained acceptance with the observed increased morbidity and mortality in SARS-CoV-2 infected patients undergoing surgery.
Objective. This study aimed to determine the outcomes of adult COVID-19 cases with acute appendicitis managed non-operatively at the Philippine General Hospital, a COVID-19 referral center, over a two-year period.
Methods. A retrospective observational study was conducted on adult patients with acute appendicitis, with SARS-CoV-2 infection, admitted from March 2020 to February 2022. Outcomes of NOM, which included treatment failure, readmission, morbidity and mortality rates, were reported.
Results: Twenty-one cases underwent NOM with a mean length of stay (LOS) of 6.8 days with no failure of NOM observed. All cases were either sent home, or transferred to an isolation facility, upon hospital discharge. There were no readmissions, morbidities and mortalities reported at 30- and 60-days after discharge. One case was readmitted after 93 days for ruptured appendicitis that required surgery. The failure rate of NOM within one year was 4.76%.
Conclusion. The study showed that NOM may be safely and effectively applied in patients with uncomplicated acute appendicitis as an alternative to surgery in patients with COVID-19 infection. This approach, however, requires close monitoring and early recognition of treatment failure.