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Trends in Pediatric Appendicitis and Imaging Strategies During Covid-19 in the United States

Shireen E Hayatghaibi1, Andrew T Trout2, Jonathan R Dillman3

  • 1Department of Radiology, Texas Children's Hospital, Houston Texas; University of Texas, School of Public Health, Houston, Texas.

Academic Radiology
|September 8, 2021
PubMed

Insights

During the COVID-19 pandemic, the proportion of complicated appendicitis in children rose, while uncomplicated cases declined. Imaging strategies for appendicitis remained largely unchanged.

Area of Science:

  • Pediatric Surgery
  • Epidemiology
  • Infectious Diseases

Background:

  • The COVID-19 pandemic significantly impacted healthcare delivery globally.
  • Changes in pediatric appendicitis presentation and management during the pandemic are not fully understood.

Purpose of the Study:

  • To assess changes in the proportion of complicated appendicitis in children during the initial COVID-19 wave.
  • To evaluate shifts in imaging strategies for pediatric appendicitis during the pandemic.

Main Methods:

  • A retrospective cross-sectional study utilized administrative data from the Pediatric Health Information System.
  • Data from March-May 2020 (COVID-19 period) were compared to pre-pandemic periods (2017-2019).
  • Outcomes included the proportion of complicated appendicitis and imaging trends.

Main Results:

  • The proportion of complicated appendicitis increased by 4.4% (46.5% pre-COVID-19 to 50.9% during COVID-19, p < 0.001).
  • Uncomplicated appendicitis cases decreased, while complicated cases remained numerically stable.
  • Ultrasound remained the predominant imaging modality, with no significant change in overall imaging approaches.

Conclusions:

  • The first wave of COVID-19 saw a higher proportion of complicated appendicitis diagnoses in children.
  • This shift was driven by a decrease in uncomplicated cases, not an increase in complicated ones.
  • Pediatric appendicitis imaging practices were largely unaffected by the pandemic's initial phase.
Abstract

Keywords:
AppendicitisCOVID-19OutcomesPediatrics

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