Impact of the COVID-19 Pandemic on Pediatric Acute Appendicitis
DOI:
https://doi.org/10.35434/rcmhnaaa.2024.173.2472Keywords:
Appendicitis, COVID-19, pandemics, child, surgeryAbstract
Background: The COVID-19 pandemic implied the modification of the entire healthcare system including paediatric surgical practice, with delays in diagnosis and increased morbidity. The aim of the study was to analyze its influence on the rate of perforated appendicitis and its complications in children during the first 9 months of the pandemic compared to the same period of the previous year.
Methods: Observational, cross-sectional analytical study; included patients younger than 15 years with acute appendicitis who required emergency surgery during the periods from April to December 2019 (pre-pandemic group) and April to December 2020 (pandemic group). The rate of perforated appendicitis in each group was analyzed, as well as postoperative complications, hospital stay, readmissions, associated symptoms and demographic variables.
Results: There were 108 patients included in each cohort, there were no significant differences in age (p = 0.799), sex (p = 0.165) or associated symptoms such as abdominal pain (p = 0.783), fever (p = 0.890), nausea/vomiting (p = 0.784) and diarrhea (p = 0.685). The proportion of perforated appendicitis was 39.8% in the pandemic group and 34.3% in prepandemic (p = 0.398). No differences were found in postoperative complications (p = 0.394), hospital stay (p = 0.189) or readmissions (p = 0.249).
Conclusions: The incidence of perforated appendicitis and complications of appendectomy in children was not modified by the COVID-19 pandemic.
Downloads
Metrics
References
Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K, et al. Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis. Int J Surg. 2021; 95:106148.
Almaramhy HH. Acute appendicitis in young children less than 5 years: review article. Ital J Pediatr. 2017;43(1):15.
Zavras N, Vaos G. Management of complicated acute appendicitis in children: Still an existing controversy. World J Gastrointest Surg. 2020;12(4):129–37.
Lounis Y, Hugo J, Demarche M, Seghaye MC. Influence of age on clinical presentation, diagnosis delay and outcome in pre-school children with acute appendicitis. BMC Pediatr. 2020;20(1):151.
Pogorelić Z, Domjanović J, Jukić M, Peričić TP. Acute Appendicitis in Children Younger than Five Years of Age: Diagnostic Challenge for Pediatric Surgeons. Surg Infect. 2020; 21(3):239 - 45.
Lossio J. Covid-19 en el Perú: respuestas estatales y sociales. Hist Cienc Saúde-Manguinhos. 2021; 28(2):581- 5.
Gunadi, Idham Y, Paramita VMW, Fauzi AR, Dwihantoro A, Makhmudi A. The Impact of COVID-19 pandemic on pediatric surgery practice: A cross-sectional study. Annals of Medicine and Surgery. 2020; 59:96 - 100.
Tankel J, Keinan A, Blich O, Koussa M, Helou B, Shay S, et al. The Decreasing Incidence of Acute Appendicitis During COVID-19: A Retrospective Multi-Centre Study. World J Surg. 2020; 44(8):2458 - 63.
Perú. Ministerio de Salud. Decreto Supremo N° 008-2020-SA por el cual se declara en Emergencia Sanitaria a nivel nacional por el plazo de noventa (90) días calendario y dicta medidas de prevención y control del COVID-19. Diario Oficial El Peruano, 15305 (Mar. 11, 2020)
Esparaz JR, Chen MK, Beierle EA, Anderson SA, Martin CA, Mortellaro VE, et al. Perforated Appendicitis During a Pandemic: The Downstream Effect of COVID-19 in Children. Journal of Surgical Research. 2021; 268:263 - 6.
Saverio SD, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020; 15(1): 27.
Howell EC, Dubina ED, Lee SL. Perforation risk in pediatric appendicitis: assessment and management. Pediatric Health Med Ther. 2018; 9:135 - 45.
Li C, Saleh A. Effect of COVID-19 on pediatric appendicitis presentations and complications. Journal of Pediatric Surgery. 2022; 57(5):861- 5.
O’Reilly C, Ng-Kamstra J, Kania-Richmond A, Dort J, White J, Robert J, et al. Surgery and COVID-19: a rapid scoping review of the impact of the first wave of COVID-19 on surgical services. BMJ Open. 2021; 11(6): e043966
Davenport M, Pakarinen MP, Tam P, Laje P, Holcomb GW. From the editors: The COVID-19 crisis and its implications for pediatric surgeons. J Pediatr Surg. 2020; 55(5):785 - 8.
Motazedian G, Aryanpoor P, Rahmanian E, Abiri S, Kalani N, Hatami N, et al. Incidence of Pediatric Perforated Appendicitis during the COVID-19 Pandemic; a Systematic Review and Meta-Analysis. Arch Acad Emerg Med. 2022;10(1): e3
Kanamori D, Kurobe M, Sugihara T, Harada A, Kaji S, Uchida G, et al. Increase in pediatric complicated appendicitis during the COVID-19 pandemic: a multi-center retrospective study. Surg Today. 2022; 52(12): 1741–1745.
Velayos M, Muñoz-Serrano AJ, Estefanía-Fernández K, Sarmiento Caldas MC, Moratilla Lapeña L, López-Santamaría M, et al. Influencia de la pandemia por coronavirus 2 (SARS-Cov-2) en la apendicitis aguda. An Pediatr. 2020; 93(2):118 -122.
Bhangu A, Søreide K, Di Saverio S, Assarsson JH, Drake FT. Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet. 2015; 386:1278–1287
Delgado-Miguel C, García Urbán J, Del Monte Ferrer C, Muñoz-Serrano A, Miguel-Ferrero M, Martínez L. Impact of the COVID-19 pandemic on acute appendicitis in children. Healthc Qual Res. 2022; 37(4):225-230.
Ornell F, Schuch JB, Sordi AO, Kessler FHP. “Pandemic fear” and COVID-19: mental health burden and strategies. Braz J Psychiatry. 2020;42(3):232–5.
Meltzer JA, Kunkov S, Chao JH, Tay ET, George JP, Borukhov D, et al. Association of Delay in Appendectomy with Perforation in Children with Appendicitis. Pediatr Emerg Care. 2019; 35(1):45-49.
Bonilla L, Gálvez C, Medrano L, Benito J. Impacto de la COVID-19 en la forma de presentación y evolución de la apendicitis aguda en pediatría. An Pediatr. 2021;94(4):245–51.
Rodríguez MGT, Reyes MD, Castaño IM, Colomer PD, Goenechea AE, Piñera JG. ¿Han aumentado las complicaciones de las apendicitis agudas en niños por el impacto del SARS-CoV-2?. Cir Pediatr. 2022; 35: 131-134.
Roberts K. Impact of COVID‐19 on appendicitis presentations in children in Australia and New Zealand. ANZ J Surg. 2022;92(4):736 - 41.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 Edward Ocampo Anduaga, Judith Vilma Apaza Yupanqui
This work is licensed under a Creative Commons Attribution 4.0 International License.