Manejo de Apendicite Aguda Durante a Pandemia de COVID-19 em um Hospital de Referência no Brasil
DOI:
10.46551/ruc.v22n2a06Palabras clave:
Apendicite, Abdome agudo, SARS-CoV-2, CoronavírusResumen
Objetivo: Comparar dados epidemiológicos e clínicos, acesso a exames diagnósticos e tempo do início dos sintomas até o tratamento cirúrgico de pacientes com apendicite aguda (AA) durante a pandemia de COVID-19 ao período correspondente do ano anterior (não pandêmico). Métodos: Trata-se de um estudo transversal, analítico e retrospectivo, realizado a partir de registros médicos de pacientes com AA em um hospital de referência em Montes Claros – Minas Gerais, Brasil. Resultados: Na vigência da pandemia, houve acréscimo de 10,7% nos casos de AA; o acesso à propedêutica não apresentou diferença estatisticamente significativa (exames laboratoriais: p = 0,059; ultrassonografia de abdome: p = 0,576 e tomografia computadorizada de abdome: p = 0,593) e o tratamento cirúrgico foi realizado em todos os pacientes com diagnóstico de AA, não sendo indicado tratamento conservador. Prevaleceram achados de AA em fases iniciais nos exames anatomopatológicos das peças cirúrgicas, sem diferença estatística nos períodos avaliados (p = 0,905). Conclusões: Apesar da sobrecarga dos serviços de saúde durante o período pandêmico, não houve diferença estatisticamente significativa dos dados epidemiológicos e clínicos, do acesso aos exames laboratoriais e de imagem, assim como da indicação e realização de procedimento cirúrgico da AA, contribuindo para o manejo dessa patologia de modo correlato ao período não pandêmico.
Descargas
Citas
CORONAVÍRUS: o mapa que mostra o alcance mundial da doença. BCC news, Brasil, 3 de mar. de 2020. Disponível em <https://www.bbc.com/portuguese/internacional-51718755 >. Acesso em: 18 Jan. de 2021
COLLARD, Maxime et al. Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: changes in treatment modalities related to the COVID-19 health crisis. Journal of Visceral Surgery, v. 157, p. S33–S42, 2020.
NGASERIN, Sabrina Hui-na et al. COVID-19 not detected in peritoneal fluid: a case of laparoscopic appendicectomy for acute appendicitis in a COVID-19-infected patient. Langenbecks Arch Surg, v. 405, p. 353-355, 2020
MASROOR, Saqib. Collateral damage of COVID‐19 pandemic: Delayed medical care. Journal of Cardiac Surgery, v. 35, p. 1345–1347, 2020.
MATTSON, Bradley.; DULAIMY, Kal. The 4 quadrants: acute pathology in the abdomen and current imaging guidelines. Seminars in Ultrasound, CT and MRI, v. 38, p. 414-423, Aug 2017.
D'SOUZA, Nigel.; NUGENT, Karen. Appendicitis. Am Fam Physician, v. 93, n. 2, p. 142-143, Jan 2016
KEARNEY, Cahill, et al. Influence of delays on perforation risk in adults with acute appendicitis. Diseases of the Colon and Rectm, v. 51, n.12, p. 1823-1827, Jun 2008.
MURPHY, E.; MEALY, K. Timimg of operation for appendicitis. The British Journal of Surgery, v. 84, n. 7, p. 1004-1005, Jun 1997.
JAVANMARD-EMAMGHISSI, Hannah et al. The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study. Techniques in coloproctology, p. 1-11, Jul 2020.
TANKEL, James et al. The Decreasing Incidence of Acute Appendicitis During COVID-19: A Retrospective Multi-centre Study. World J Surg, 44, n. 8, p. 2458-2463, May 2020.
ORTHOPOULOS, Georgious et al. Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am J Surg, Online ahead of print, Sep 2020.
ENGLISH, William et al. Investigation and management of suspected appendicitis during the COVID‐19 pandemic. The British Journal of Surgery, v. 107, n. 9, p. e337, July 2020.
SLIM, Karem.; VEZIANT, Julie. La chirurgie digestive urgente, victime collatérale de la crise du Covid-19? Journal De Chirurgie Viscerale, v. 157, n. 3, p. S4–S5, Jun 2020.
CANO-VALDERRAMA, Oscar et al. Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study. Int J Surg, v. 80, p. 157-161, Aug 2020.
GAO, Zhinguang et al. Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV). Asian Journal of Surgery, v. 43, p. 1002-1005, Aug 2020.
ZVIZDIC, Zlatan.; VRANIC, Semir. Decreased number of acute appendicitis cases in pediatric population during the COVID-19 pandemic: Any link? J Pediatr Surg, Aug 2020.
FERRIS, Mollie et al. The Global Incidence of Appendicitis: A Systematic Review of Population-based Studies. Ann Surg, v. 266, n. 2, p. 237-241, Aug 2017.
PAN, Lei et al. Clinical Characteristics of COVID-19 Patients With Digestive Symptoms in Hubei, China: A Descriptive, Cross-Sectional, Multicenter Study. Am J Gastroenterol, v. 115, n. 5, p. 766-773, May 2020.
LIANG, Weicheng et al. Diarrhoea may be underestimated: a missing link in 2019 novel coronavirus. Gut, v. 69, n. 6, p. 1141-1143, Jun 2020.
ROMERO, Javier.; VALENCIA, Sergio.; GUERRERO, Andres. Acute appendicitis during coronavirus disease 2019 (COVID-19): changes in clinical presentation and CT findings. Journal of the American College of Radiology, v. 17, n. 8, p. 1011-1013, Jun 2020.
SCOTT, Charles.; LAMBERT, Anthony. Managing appendicitis during the COVID‐19 pandemic in the UK. The British Journal of Surgery, v. 107, n. 8, p. e271, Jun 2020.
BRASIL. Lei nº 8.080, de 19 de Setembro de 1990. Brasília 1990.
PARREIRA, José Gustavo et al. Management of non traumatic surgical emergencies during the COVID-19 pandemia. Rev Col Bras Cir, v. 47, p. e20202614, July 2020.
COIMBRA, Raul et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg, v. 46, n. 3, p. 505-510, Jun 2020.
KULACHANYA, Suwanwongse.; NEHAD, Shabarek. Successful Conservative Management of Acute Appendicitis in a Coronavirus Disease 2019 (COVID-19) Patient. Cureus, v. 12, n. 4, 2020.
KELLY, Michael Eamon et al. COVID-19 and the treatment of acute appendicitis in Ireland: a new era or short-term pivot? Colorectal Dis, v. 22, n. 6, p. 648-649, Jun 2020.