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How Does the COVID-19 Pandemic Affect Pediatric Patients with Intussusception Treated by Ultrasound-Guided
Min Yang1, Ze-Hui Gou2, Jun Wang2
1Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Insights
The COVID-19 pandemic delayed intussusception diagnosis and worsened symptoms in children. However, ultrasound-guided hydrostatic enema reduction (USGHER) procedures and patient outcomes remained unaffected.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Epidemiology
Background:
- COVID-19 pandemic significantly impacted intussusception epidemiology.
- Effects on ultrasound-guided hydrostatic enema reduction (USGHER) for intussusception were largely unknown.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on USGHER for pediatric intussusception.
- To compare outcomes between pre-pandemic, early pandemic, and later pandemic periods.
Main Methods:
- Retrospective analysis of pediatric patients treated with USGHER from 2019 to 2021.
- Comparison of diagnostic delays, clinical manifestations, and procedural parameters across three groups (2019, 2020, 2021).
Main Results:
- Study Group 1 (2020) showed significantly longer delays in diagnosis and presentation of more severe symptoms (bloody stool, longer invagination length).
- No significant differences were observed in enema pressure or duration during USGHER among the groups.
- No perforations occurred, and intussusception recurrence was minimal across all groups.
Conclusions:
- The COVID-19 pandemic contributed to diagnostic delays and clinical deterioration in pediatric intussusception.
- USGHER procedure itself and patient outcomes were not significantly compromised by the pandemic.
- Findings highlight the need for timely diagnosis and management of intussusception, even during public health crises.
Background:
The pandemic of COVID-19 has significantly influenced the epidemiology of intussusception. Nevertheless, the effects of the COVID-19 pandemic on the operation of ultrasound-guided hydrostatic enema reduction (USGHER) for intussusception have been largely unknown.
Methods:
The data of pediatric patients with intussusception who were treated by USGHER from January to March of 2019 (Control Group), 2020 (Study Group 1), and 2021 (Study Group 2) in a large Chinese medical institution were retrospectively collected and analyzed.
Results:
We enrolled 246 patients, including 90 cases in Control Group, 70 in Study Group 1, and 86 in Study Group 2 (p = 0.042). The time from the onset of symptoms to the hospital visit and the time from the hospital visit to performing the ultrasound in Study Group 1 was significantly longer than that in Control Group and Study Group 2 (p = 0.036, p = 0.031, respectively). The number of patients with bloody stool and the longest invaginated length of intussusception in Study Group 1 increased significantly compared with patients in the other two groups (p = 0.007, p = 0.042, respectively). Comparisons of neither the pressure of enema nor the time of duration when performing USGHER present statistical significance among the three groups (p = 0.091, p = 0.085, respectively). For all enrolled pediatric patients, there was no perforation case involved, and recurrence of intussusception occurred in few cases.
Conclusions:
Besides the negative impacts on the incidence of intussusception, the COVID-19 pandemic might have led to the diagnostic delay of intussusception and the deterioration of patients' clinical manifestations, but it did not significantly affect the operation of USGHER and patients' clinical outcome.
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