An indirect effect of COVID-19 pandemic: Increased pediatric perforated appendicitis rate due to delayed admission
Ergun Ergün1, Sümeyye Sözduyar1, Aynur Gurbanova1, Fırat Serttürk1, Ergin Çiftçi2, Halil Özdemir2, Gül Arga2, Hatice Kübra Konca2, Güle Çınar3, İrem Akdemir Kalkan3, Ezgi Gülten3, Özlem Selvi Can4, Birsel Şen Akova5, Ömer Suat Fitöz5, Göksel Vatansever6, Deniz Tekin6, Gülnur Göllü1, Meltem Bingöl-Koloğlu1, Aydın Yağmurlu1, Murat Çakmak1, Ufuk Ateş1
1Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
2Division of Pediatric Infectious Disease, Ankara University Faculty of Medicine, Ankara, Turkey
3Department of Infectious Diseases and Clinical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
4Department of Anesthesia and Reanimation, Ankara University Faculty of Medicine, Ankara, Turkey
5Division of Pediatric Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
6Division of Pediatric Emergency, Ankara University Faculty of Medicine, Ankara, Turkey
Objective: Appendicitis is a common surgical emergency among children. The coronavirus pandemic affected the system of hospitals more than any other field, and great amount of people were concerned about visiting the hospitals for any reason. In this study, it was aimed to evaluate the profile of appendicitis by emphasizing perforated and acute appendicitis in the pandemic period and to compare the rates with previous three years.
Material and Methods: Charts of the children who underwent laparoscopic appendectomy due to appendicitis between March 11-September 30 between 2017-2020 were retrospectively analyzed in terms of demographic data, duration of symptoms, duration between hospital admission and surgery, radiologic imaging and perioperative outcomes.
Results: This study includes 467 children who underwent laparoscopic appendectomy. There were 97 procedures in 2020, 111 in 2019, 146 in 2018 and 113 in 2017. Multiple comparison tests revealed that age did not show difference; but onset of symptoms in admission (p= 0.004), hospitalization time before surgery (p< 0.001), total hospitalization time (p< 0.001) showed statistically significant difference between years. Pairwise comparisons showed that these parameters were increased in 2020 compared to other years. Perforated appendicitis rate was significantly increased in 2020 when compared to previous years.
Conclusion: Although there is no direct relation between appendicitis and COVID-19 infection in the current knowledge, perforated appendicitis was found to be increased in children during the COVID pandemic. Reason of the higher rate of perforated appendicitis may be multifactorial; however, the pandemic appears to have a role in increased morbidity in children with appendicitis indirectly due to delay of hospital admissions.
Keywords: Appendicitis, child, coronavirus, pandemic, pediatric surgery
This study approval was obtained from Ankara University Human Researches Ethical Committee (Decision No: İ1-67- 21, Date: 28.01.2021).
Concept - All of authors; Design - All of authors; Supervision - All of authors; Data Collection and/or Processing - All of authors; Analysis and/or Interpratation - All of authors; Literature Review - All of authors; Writing Manuscript - All of authors;Critical Reviews - All of authors.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.