Paediatric appendicitis during the COVID-19 pandemic

Area of Science:

• Pediatric Surgery
• Infectious Disease Epidemiology
• Public Health

Background:

• The COVID-19 pandemic's impact on healthcare access and patient presentation patterns is a growing concern.
• While adult appendicitis trends during the pandemic are noted, the pediatric population remains understudied.
• Understanding changes in pediatric appendicitis presentation and management is crucial for timely intervention.

Purpose of the Study:

• To evaluate the effect of the COVID-19 pandemic on the presentation and management of pediatric appendicitis.
• To compare appendicitis cases during the pandemic lockdown period with a pre-pandemic control group.
• To identify any changes in diagnostic rates, severity, and treatment outcomes.

Main Methods:

• A comparative study analyzing data from pediatric patients admitted with right iliac fossa pain.
• Data collected during the COVID-19 pandemic period (March-June 2020) were compared to a control group from the prior year (March-June 2019).
• Key metrics included diagnostic rates, time to presentation, inflammatory markers, surgical intervention timing, and patient outcomes.

Main Results:

• A significantly higher proportion of pediatric patients were diagnosed with appendicitis during the COVID-19 period (24% vs. 10%).
• Patients presented later (3 days vs. 1 day) with elevated inflammatory markers during the pandemic.
• Despite delayed presentation, the majority underwent surgery promptly, with no significant difference in complicated appendicitis or patient morbidity between groups.

Conclusions:

• Paediatric appendicitis presentation patterns shifted during the COVID-19 pandemic, characterized by delayed arrival and increased diagnosis rates.
• Prompt surgical management was maintained, leading to favorable outcomes and no increased morbidity in pediatric appendicitis patients.
• This highlights the resilience of pediatric surgical care despite pandemic-related challenges.