Did the COVID-19 Pandemic Prolong the Time Till Diagnosis and Worsen Outcomes for Children with Acute Appendicitis?

Area of Science:

• Pediatric Surgery
• Epidemiology
• Public Health

Background:

• The COVID-19 pandemic introduced unprecedented public health measures, including lockdowns and quarantine periods.
• These measures may have impacted healthcare access and timeliness for various medical conditions, including surgical emergencies.

Purpose of the Study:

• To evaluate the effect of the COVID-19 pandemic on the timing of diagnosis and surgery for acute appendicitis in children.
• To determine if the pandemic influenced the rates of complicated appendicitis and postoperative complications in pediatric patients.

Main Methods:

• Retrospective analysis of pediatric patients with acute appendicitis.
• Comparison of data from a 4-month period during the first COVID-19 pandemic wave with the same period in the preceding year (2019).

Main Results:

• A significant increase in time spent in the emergency room (ER) before admission and in the hospital department before surgery was observed during the pandemic.
• Despite delays in ER and pre-operative care, the overall time from symptom onset to operation, hospital length of stay, complicated appendicitis rates, and postoperative complication rates did not significantly differ between the pandemic and pre-pandemic periods.

Conclusions:

• COVID-19-related quarantine measures led to a notable delay in surgical intervention for pediatric appendicitis.
• This delay did not correlate with an increased incidence of complicated appendicitis or postoperative complications, suggesting potential flexibility in surgical timing for this condition.