Investigating changes in incidence and severity of pediatric appendicitis during the COVID-19 pandemic in Canada: an interrupted time series analysis

Giorgio, Francesca del; Habti, Merieme; Merckx, Joanna; Kaufman, Jay S.; Gravel, Jocelyn; Piché, Nelson; Osmanlliu, Esli; Drouin, Olivier

doi:10.1007/s12519-022-00656-9

Cited by 4 publications

(6 citation statements)

References 18 publications

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“…Additionally, fewer pandemic-cohort patients consulted with primary care physicians whereas the numbers of complicated appendicitis cases, LOSs and complication rates showed no differences [46]. Comparable results were reported by Del Giorgio et al [50]. Some studies identified a significant increase in perforated case numbers during the pandemic despite similar durations of symptoms [25,26,45].…”

Section: Time To Hospital Admission Duration Of Symptoms and In-hospi...mentioning

confidence: 68%

Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review

et al. 2023

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Global pandemics cause health system disruptions. The inadvertent disruption in surgical emergency care during the Coronavirus Disease 2019 (COVID-19) pandemic has been the topic of several published studies. Our aim was to summarize the reasons that led to the delayed diagnosis of pediatric appendicitis during the COVID-19 era. This systematic literature search evaluated studies containing pediatric appendicitis patient data regarding outcomes, times to hospital admission or times from symptom onset to emergency department visit. Studies elucidating reasons for delays in the management of pediatric appendicitis were also reviewed. Ultimately, 42 studies were included. Several reasons for delayed diagnosis are analyzed such as changes to public health measures, fear of exposure to COVID-19, increased use of telemedicine, COVID-19 infection with concurrent acute appendicitis, recurrence of appendicitis after non-operative management and increased time to intraoperative diagnosis. Time to hospital admission in conjunction with patient outcomes was extracted and analyzed as an indicative measure of delayed management. Delayed diagnosis of acute appendicitis has been documented in many studies with various effects on outcomes. Suspicion of pediatric acute appendicitis must always lead to prompt medical examination, regardless of pandemic status. Telemedicine can be valuable if properly applied. Data from this era can guide future health system policies.

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Section: Time To Hospital Admission Duration Of Symptoms and In-hospi...mentioning

confidence: 68%

Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review

et al. 2023

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“…Of 528 title/abstract screened, 129 full-text articles were analyzed, 43 studies entered the qualitative analysis [ 1 – 11 , 13 , 14 , 22 – 51 ], and 36 papers were included in the meta-analysis [ 1 – 8 , 11 , 13 , 22 , 23 , 25 – 28 , 30 – 44 , 46 – 50 ] (32,704 pts, Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

Management and outcomes of acute appendicitis in children during the COVID-19 pandemic: a systematic review and meta-analysis

Miscia,

Lauriti,

Di Renzo

et al. 2023

Pediatr Surg Int

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The COVID-19 pandemic has changed the way to manage the emergencies, as people faced fear of the hospitals, with possible delay in the diagnosis. Moreover, clinicians had to rearrange protocols for diagnosis and treatment. We aimed to assess whether COVID-19 pandemic influenced severity of inflammation, management, and outcomes of acute appendicitis (AA), when compared to the pre-COVID era. Using defined search strategy, two independent investigators identified those studies comparing pediatric AA during COVID-19 pandemic versus the pre-COVID-19 period. Meta-analysis was performed using RevMan 5.3. Data are mean ± SD. Of 528 abstracts, 36 comparative studies were included (32,704pts). Time from symptoms onset to surgery was longer during the pandemics compared to the pre-COVID-19 (1.6 ± 0.9 versus 1.4 ± 0.9 days; p < 0.00001). Minimally Invasive Surgery was similar during COVID-19 (70.4 ± 30.2%) versus control period (69.6 ± 25.3%; p = ns). Complicated appendicitis was increased during the pandemics (35.9 ± 14.8%) compared to control period (33.4 ± 17.2%; p < 0.0001). Post-operative complications were comparable between these two groups (7.7 ± 6.5% versus 9.1 ± 5.3%; p = ns). It seems that the COVID-19 pandemic influenced the time of diagnosis, severity of inflammation, and type of surgery. However, the number of post-operative complications was not different between the two groups, leading to the conclusion that the patients were correctly managed. Level of Evidence Level 3 Meta-analysis on Level 3 studies

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“…We would like to thank Quaglietta et al [1] for their interest in our study and making their data available to allow comparison with our article [2] on the impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric appendicitis.…”

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confidence: 99%

“…We agree with the authors that our article could not reflect the experience of all hospitals and provinces in Canada. The comparison of both articles [1,2] highlights the fact that multiple factors can impact the risk of complications among children with appendicitis. Beyond common national policies, different provincial and local influences may affect health outcomes.…”

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confidence: 99%

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et al. 2023

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Investigating changes in incidence and severity of pediatric appendicitis during the COVID-19 pandemic in Canada: an interrupted time series analysis

Cited by 4 publications

References 18 publications

Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review

Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review

Management and outcomes of acute appendicitis in children during the COVID-19 pandemic: a systematic review and meta-analysis

Response to “Incidence and severity of pediatric appendicitis during the COVID‑19 pandemic”

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