Concurrent COVID-19 infection in children with acute appendicitis: A report of three cases

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Viral Pathogenesis

Background:

• Understanding the clinical presentation of pediatric acute appendicitis concomitant with SARS-CoV-2 infection is crucial for effective management.
• Growing literature highlights the association between COVID-19 and acute appendicitis in children, necessitating further case study analysis.

Observation:

• Three male pediatric patients underwent surgical treatment for acute appendicitis alongside concurrent SARS-CoV-2 infection.
• One patient, despite lacking typical COVID-19 respiratory symptoms, presented with leukopenia, elevated C-reactive protein, and imaging consistent with appendicitis and viral pulmonary infection, ultimately diagnosed with perforated appendicitis.
• Two other patients had confirmed SARS-CoV-2 infection, with one testing positive for a month prior and remaining asymptomatic, while the third presented with appendicitis symptoms but no apparent COVID-19 manifestations.

Findings:

• The cases illustrate varied presentations of pediatric appendicitis in the context of COVID-19.
• An unusual case involved perforated appendicitis with an asymptomatic COVID-19-related pulmonary infection.
• More commonly, pediatric patients exhibited acute appendicitis with asymptomatic SARS-CoV-2 infection.

Implications:

• These findings underscore the importance of considering COVID-19 in pediatric patients presenting with appendicitis, even in the absence of respiratory symptoms.
• The varied clinical pictures emphasize the need for thorough diagnostic evaluation in pediatric surgical emergencies during the pandemic.
• Further research is warranted to elucidate the complex interplay between SARS-CoV-2 infection and acute appendicitis in pediatric populations.