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SARS-CoV-2 Pandemic--A Complicated Case of Appendicitis.

A 21-year-old woman with suspected appendicitis (Alvarado score 5) was assigned to the COVID-positive area of the emergency room because she also reported temperature readings of up to 39.3 ° C, diarrhea, and cold symptoms. Laboratory tests revealed leukocytopenia (3.75/nL). This combination of leukocytopenia and cold symptoms, atypical for appendicitis, prompted consideration of COVID-19, which sometimes features abdominal manifestations. In the absence of a rapid test for SARS-CoV-2, we ordered computed tomography of the chest and abdomen. Imaging detected acute appendicitis accompanied by an infiltrate suggestive of COVID-19. The patient’s respiration was stable, so after weighing up the risks, and with the patient’s consent, we carried out laparoscopic appendectomy. All appropriate precautions were observed. Postoperative extubation was unproblematic and the recovery uncomplicated. The swab taken at arrival later turned out to be positive for COVID-19. Pathological examination revealed ulcerophlegmonous appendicitis. Detection of mild COVID-19 disease is crucial for the prevention of spread to hospital employees and other patients.