Frequency of viral infection of peritoneal effusion in patients with acute appendicitis and COVID-19

• Strizheletsky V.V.
• Flora М. Sultanova
• Ivanov I.G.
• Rutenburg G.M.
• Fadeeva E.A.

Abstract

The aim of the study is to define the frequency of viral infection of peritoneal effusion in patients with acute appendicitis and COVID-19.

Material and methods. From March 2020 to April 2023, 208 appendectomies for acute appendicitis in patients with COVID-19 were performed in St. George Hospital, St. Petersburg. The criteria for inclusion were: a positive result of polymerase chain reaction to SARS-CoV-2, and / or a characteristic picture of viral pneumonia according to the results of CT; inflammatory changes in the appendix; the presence of effusion in the abdominal cavity in patients

Results. Serous effusion in the right iliac fossa and pelvis was detected during diagnostic laparoscopy in 156 (75%) patients. Purulent effusion was found in 52 (25%) patients, of which 7 patients had widespread peritonitis, 45 had local peritonitis. In all cases, the exudate was sent for PCR analysis to detect SARS-CoV-2 and for bacteriological examination. The PCR result was positive in 147 (70.67%) cases. No growth was detected in 113 patients (54.33%) according to the results of a bacteriological study, an association was detected in 34 (16.35%) cases (positive PCR for SARS-CoV-2, the presence of bacterial growth). The greatest number of cases of detection of SARS-CoV-2 in peritoneal fluid was observed in patients who had symptoms characteristic of COVID-19 within 5 days before surgery.

Conclusion. In patients with acute appendicitis and COVID-19 SARS-CoV-2 can be determined by PCR, and therefore it is necessary to strictly observe antiepidemic measures during surgery.

Keywords:appendicitis; appendectomy; laparoscopic appendectomy; COVID-19

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