Adriana Yock-Corrales1, Jacopo Lenzi, Rolando Ulloa-Gutiérrez, Jessica Gómez-Vargas, Omar Yassef Antúnez-Montes, Jorge Alberto Rios Aida, Olguita Del Aguila, Erick Arteaga-Menchaca, Francisco Campos, Fadia Uribe, Roger Hernando Diaz, Andrea Parra Buitrago, Lina Maria Betancur Londoño, Verónica Kozicki, Martin Brizuela, Danilo Buonsenso. 1. From the Pediatric Emergency Department, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", CCSS, San José, Costa Rica; Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy; Infectious Disease Department, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", CCSS, San José, Costa Rica; Departamento de Docencia e Investigación, Instituto Latinoamericano de Ecografía en Medicina (ILEM), Ciudad de Mexico, Mexico; CLÍNICA JAS MÉDICA, Lima, Perù; Department of Pediatrics, Unidad de Infectología Pediátrica del Hospital Nacional Edgardo Rebagliati Martins-Lima-Perú; Department of Pediatrics, Hospital General Regional 200 IMSS, Mexico; epartment of Pediatrics, Hospital Madre Niño San Bartolome, Lima, Peru; Department of Pediatrics, Hospital Pablo Tobon Uribe Medellin, Colombia; Department of Pediatrics, Fundacion Neumologica Colombiana, Bogotà, Colombia; Pediatric Infectious Disease, Hospital isidoro Iriarte, Quilmes, Buenos Aires, Argentina; Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy; Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy; and Department of Pediatrics, Global Health Research Institute, Istituto di Igiene, Università Cattolica del Sacro Cuore, Roma, Italia.
Abstract
BACKGROUND: To date, there are only sporadic reports of acute abdomen and appendicitis in children with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C). METHODS: Children 17 years of age or younger assessed in 5 Latin American countries with a diagnosis of microbiologically confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and children fulfilling MIS-C definition were included. For children with acute abdomen, we investigate main radiological patterns, surgical treatment and intraoperative findings, outcomes. FINDINGS: One-thousand ten children were enrolled. Forty-two children (4.2%) had a clinical diagnosis of acute abdomen. Four (9.5%) were diagnosed with MIS-C and did not undergo surgery. The remaining 38 children (3.8%) underwent abdominal surgery due to suspected appendicitis, 34 of them (89.7%) had an intraoperative diagnosis of acute appendicitis (AA), while 4 of them had nonsurgical findings. Eight children died (0.8%), none of them being diagnosed with appendicitis. Children with AA were significantly older than those without (P < 0.0001). Children with complicated appendicitis had more frequently fever (85.7% vs. 60%), intestinal distension on the abdominal radiograph (7.1% vs. none), leukocytosis (85.7% vs. 40%) and high levels of C-reactive protein (35.7% vs. 5%), although differences were not statistically significant. CONCLUSIONS: Our study showed that children may present with acute abdomen during COVID-19 or MIS-C, which is not always associated with intraoperative findings of appendicitis, particularly in case of MIS-C. Further studies are needed to better characterize children with acute abdomen during COVID-19 or MIS-C, to avoid delay in diagnosis of surgical conditions and at the same time, minimize unnecessary surgical approaches.
BACKGROUND: To date, there are only sporadic reports of acute abdomen and appendicitis in children with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C). METHODS:Children 17 years of age or younger assessed in 5 Latin American countries with a diagnosis of microbiologically confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and children fulfilling MIS-C definition were included. For children with acute abdomen, we investigate main radiological patterns, surgical treatment and intraoperative findings, outcomes. FINDINGS: One-thousand ten children were enrolled. Forty-two children (4.2%) had a clinical diagnosis of acute abdomen. Four (9.5%) were diagnosed with MIS-C and did not undergo surgery. The remaining 38 children (3.8%) underwent abdominal surgery due to suspected appendicitis, 34 of them (89.7%) had an intraoperative diagnosis of acute appendicitis (AA), while 4 of them had nonsurgical findings. Eight children died (0.8%), none of them being diagnosed with appendicitis. Children with AA were significantly older than those without (P < 0.0001). Children with complicated appendicitis had more frequently fever (85.7% vs. 60%), intestinal distension on the abdominal radiograph (7.1% vs. none), leukocytosis (85.7% vs. 40%) and high levels of C-reactive protein (35.7% vs. 5%), although differences were not statistically significant. CONCLUSIONS: Our study showed that children may present with acute abdomen during COVID-19 or MIS-C, which is not always associated with intraoperative findings of appendicitis, particularly in case of MIS-C. Further studies are needed to better characterize children with acute abdomen during COVID-19 or MIS-C, to avoid delay in diagnosis of surgical conditions and at the same time, minimize unnecessary surgical approaches.
Authors: Danilo Buonsenso; Francesco Mariani; Luca Pierri; Rosa Morello; Adriana Yock-Corrales; Olguita Del Aguila; Ilaria Lazzareschi; Giuseppe Zampino; Francesco Nunziata; Piero Valentini; Andrea Lo Vecchio Journal: Children (Basel) Date: 2022-02-17
Authors: Martín Eduardo Brizuela; Sandra Elizabeth Goñi; Georgina Alexandra Cardama; María Alejandra Zinni; Alejandro Andres Castello; Leandro Matías Sommese; Hernán Gabriel Farina Journal: Front Pediatr Date: 2022-07-07 Impact factor: 3.569