Abstract

Aim: COVID-19 was declared pandemic in March 2020. Turkish government issued stay-at-home orders and hospitals cancelled non-emergent surgeries. Our aim was to assess the impact of the COVID-19 pandemic on the presentation and management of pediatric appendicitis.

Materials and Methods: All appendicitis admissions between 01/03/2019-01/03/2021 were reviewed. Two groups were created: 12 months before COVID-19 (Nonpandemic Group) and 12 months after the date elective surgeries were postponed in TURKEY (01/03/2020) for COVID-19 (Pandemic Group). Patient demographics, symptoms, laboratory and imaging results, perforation status, intraoperative and pathological findings, and postoperative outcomes were analyzed.

Results: A total of 471 patients (264 Non-pandemic, 207 Pandemic) were evaluated. Age and gender of both groups did not differ significantly. There was significant increase in time between onset of symptoms and presentation to the hospital in Pandemic-group (1.0±1.8 vs 2.0±1.8 days, p<0.001). Symptoms reported at presentation included fever, abdominal pain, vomiting and anorexia; fever was more common in non-pandemic group being the only symptom significantly more prevalent (63.3% vs 36.7%, p =0.014). The proportion of patients diagnosed with complicated appendicitis was significantly higher during the COVID-19 pandemic (69.3% vs 79.7% p=0.03). CRP levels (50.4±63.8 vs77.87±79.3, p<0.001) and diagnostic sensitivity of abdominal USG (53% vs 66.7% p<0.05) was higher in pandemic group. Although standard therapy protocol was not changed mean length of hospitalization after surgery in Non-pandemic group was significantly lower (3.0±2.1 vs 3.0±1.3days p<0.001).

Conclusion: The pandemic resulted in higher proportion of complicated appendicitis, most likely as a result of parents’ delay in seeking medical care due to fear of Covid19. Although complicated appendicitis numbers were higher and time of hospitalization was lower in pandemic group there was no significant difference in number and types of complications following surgery Despite presenting later during COVID-19, pediatric patients with appendicitis were treated expediently with good outcomes.

Cite as: Çığşar Kuzu EB, Öztan MO, Erincin Ö, Toker Kurtmen B, Köylüoğlu G. Effects of Covid-19 Pandemic On Pediatric Appendicitis Management. Coc Cer Derg/Turkish J Ped Surg 2022;36(3): 9-14.