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What has changed in children's appendicitis during the COVID-19 pandemic?
Hayriye Nihan Ayyıldız1, Semih Mirapoglu1, Zeliha Akış Yıldız1
1Department of Pediatric Surgery, University of Health Sciences, Ümraniye Training and Research Hospital, İstanbul-Türkiye.
Summary
Pandemic fears led to delayed hospital visits for acute appendicitis in children. This resulted in a significant increase in perforated appendicitis cases and longer hospital stays.
Area of Science:
- Pediatric Surgery
- Infectious Disease Epidemiology
- Public Health
Background:
- Acute appendicitis is a common surgical emergency in children.
- The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges to healthcare access and patient behavior.
- Understanding the impact of the pandemic on pediatric surgical conditions is crucial for public health preparedness.
Purpose of the Study:
- To compare the clinical characteristics and treatment outcomes of acute appendicitis in children before and during the COVID-19 pandemic.
- To evaluate the effect of pandemic-related factors on the timeliness of presentation and severity of appendicitis.
- To assess changes in hospital stay duration and surgical outcomes during the pandemic.
Main Methods:
- A retrospective study comparing 601 pediatric patients operated for acute appendicitis.
- Group I: Pre-pandemic period (May 2019 - February 2020).
- Group II: Pandemic period (March 2020 - December 2020).
- Demographic, disease, and treatment data were analyzed and compared between groups.
Main Results:
- A higher proportion of appendicitis cases occurred during the pandemic period (40.9%) compared to the pre-pandemic period (59.1%).
- Delayed hospital presentation was observed during the pandemic, with only 2% presenting on day 1 versus 20.3% pre-pandemic.
- The rate of perforated appendicitis significantly increased from 10.4% pre-pandemic to 24.8% during the pandemic (p<0.01).
- Four patients operated during the pandemic tested positive for COVID-19, with no related complications.
Conclusions:
- Pandemic-related parental and public health concerns led to delayed hospital presentations for acute appendicitis in children.
- The delay in presentation was associated with a significant increase in the incidence of perforated appendicitis.
- These findings highlight the need for continued vigilance and accessible healthcare services for pediatric surgical emergencies during public health crises.
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