William T Head1, Raphael H Parrado2, Robert A Cina2. 1. College of Medicine, 158155Medical University of South Carolina, Charleston, SC, USA. 2. Division of Pediatric Surgery, Department of Surgery, 2345Medical University of South Carolina, Charleston, SC, USA.
Abstract
BACKGROUND: Appendicitis is the most common abdominal surgical emergency in children. With the rise of the Coronavirus-19 pandemic, quarantine measures have been enforced to limit the viral transmission of this disease. The purpose of this study was to identify differences in the clinical presentation and outcomes of pediatric acute appendicitis during the Coronavirus-19 pandemic. METHODS: A single-institution retrospective assessment of all pediatric patients (<18 years old) with acute appendicitis from December 2019 to June 2020 was performed at a tertiary care children's hospital. Patients were divided into two groups: (1) the Pre-COVID group presented on or before March 15, 2020, and (2) the COVID group presented after March 15, 2020. Demographic, preoperative, and clinical outcomes data were analyzed. RESULTS: 45 patients were included with a median age of 13 years [IQR 9.9 - 16.2] and 35 males (78%). 28 patients were in the Pre-COVID group (62%) and 17 in the COVID group (38%). There were no differences in demographics or use of diagnostic imaging. The COVID group did have a significantly delayed presentation from symptom onset (36 vs 24 hours, P < .05), higher Pediatric Appendicitis Scores (8 vs 6, P = .003), and longer hospital stays (2.2 vs 1.3 days, P = .04). There were no significant differences for rates of re-admission, re-operation, surgical site infection, perforation, or abscess formation. CONCLUSION: During the Coronavirus-19 pandemic, the incidence of pediatric acute appendicitis was approximately 40% lower. These children presented in a delayed fashion with longer hospital stays. No differences were noted for postoperative complications.
BACKGROUND: Appendicitis is the most common abdominal surgical emergency in children. With the rise of the Coronavirus-19 pandemic, quarantine measures have been enforced to limit the viral transmission of this disease. The purpose of this study was to identify differences in the clinical presentation and outcomes of pediatric acute appendicitis during the Coronavirus-19 pandemic. METHODS: A single-institution retrospective assessment of all pediatric patients (<18 years old) with acute appendicitis from December 2019 to June 2020 was performed at a tertiary care children's hospital. Patients were divided into two groups: (1) the Pre-COVID group presented on or before March 15, 2020, and (2) the COVID group presented after March 15, 2020. Demographic, preoperative, and clinical outcomes data were analyzed. RESULTS: 45 patients were included with a median age of 13 years [IQR 9.9 - 16.2] and 35 males (78%). 28 patients were in the Pre-COVID group (62%) and 17 in the COVID group (38%). There were no differences in demographics or use of diagnostic imaging. The COVID group did have a significantly delayed presentation from symptom onset (36 vs 24 hours, P < .05), higher Pediatric Appendicitis Scores (8 vs 6, P = .003), and longer hospital stays (2.2 vs 1.3 days, P = .04). There were no significant differences for rates of re-admission, re-operation, surgical site infection, perforation, or abscess formation. CONCLUSION: During the Coronavirus-19 pandemic, the incidence of pediatric acute appendicitis was approximately 40% lower. These children presented in a delayed fashion with longer hospital stays. No differences were noted for postoperative complications.
Authors: Brittany Hegde; Elisa Garcia; Andrew Hu; Mehul Raval; Sanyu Takirambudde; Derek Wakeman; Ruth Lewit; Ankush Gosain; Raphael H Parrado; Robert A Cina; Krista Stephenson; Melvin S Dassinger; Daniel Zhang; Moiz M Mustafa; Donna Koo; Aaron M Lipskar; Katherine Scheidler; Kyle J Van Arendonk; Patrick Berg; Raquel Gonzalez; Daniel Scheese; Jeffrey Haynes; Alexander Mina; Irving J Zamora; Monica E Lopez; Steven C Mehl; Elizabeth Gilliam; Katrina Lofberg; Brianna Spencer; Afif N Kulaylat; Brian C Gulack; Matthew Johnson; Matthew Laskovy; Pavan Brahmamdam; Aoi Shimomura; Therese Blanch; KuoJen Tsao; Bethany J Slater Journal: J Pediatr Surg Date: 2022-08-13 Impact factor: 2.549