Pediatric appendicitis in the time of the COVID‐19 pandemic: A retrospective chart review

Nassiri, Arianna M; Pruden, Roy D; Holan, Cole; Guerra, Angela D; Nganga, Peris W; Wilkinson, Matthew; Lawson, Karla A.; Allen, Coburn H.; Gregg, Victoria S; Naiditch, Jessica A.

doi:10.1002/emp2.12722

Cited by 9 publications

(7 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whilst higher complication rates and delays in the presentation of pediatric appendicitis were noted, a single-center retrospective analysis of pediatric appendicitis by Nassiri et al . 20 found no delay in presentation and no significant difference in the rates of complicated appendicitis. Another retrospective study conducted in Australia and New Zealand also concluded no difference in the presentation of symptoms and complication rates, with no delay in presentation to the emergency department 21 .…”

Section: Prevalence and Epidemiology Of Acute Appendicitis In Vulnera...mentioning

confidence: 65%

See 1 more Smart Citation

A critical appraisal on the treatment of acute appendicitis in pediatric population during the COVID-19 pandemic

Awuah

Mehta

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Acute appendicitis is one of the most common causes of abdominal pain in children. During the coronavirus disease 2019 (COVID-19) pandemic, a delay in presentation to the emergency department and a higher rate of complicated appendicitis were observed. Traditionally, operative management (laparoscopic or open appendectomy) was thought to be the best treatment strategy for acute appendicitis. However, nonoperative management with antibiotics has gained popularity in managing pediatric appendicitis during the COVID-19 era. The pandemic has posed significant challenges in the management of acute appendicitis. Cancellation of elective appendectomies, delay in seeking care due to fear of contracting COVID-19 infection, and impact of COVID-19 infection in the pediatric population have resulted in higher rates of complications. Furthermore, multiple studies have reported multisystem inflammatory syndrome in children mimicking acute appendicitis, subjecting patients to unnecessary surgery. Therefore, it is imperative to update the treatment guidelines for the management of acute appendicitis in the pediatric population during and after COVID-19 times.

show abstract

Section: Prevalence and Epidemiology Of Acute Appendicitis In Vulnera...mentioning

confidence: 65%

“…Nassiri et al . 20 found a significant increase in the use of computed tomography scans during the pandemic in children with acute appendicitis, which raises concerns about unnecessary radiation exposure.…”

Section: General Diagnosis and Symptoms Of Pediatric Appendicitismentioning

confidence: 99%

A critical appraisal on the treatment of acute appendicitis in pediatric population during the COVID-19 pandemic

Awuah

Mehta

et al. 2023

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

show abstract

“…This is true both for children with and without COVID-19, due to lockdowns and the potential for patient or family reluctance to attend hospital with presentation delayed. The impact of COVID-19 on disease severity at presentation is conflicting with the narrative differing between countries [24][25][26][27]. Higher rates of complicated appendicitis, possibly due to delays in presentation, have been reported in some populations, but this was not replicated universally.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for complications after emergency surgery for paediatric appendicitis: a national prospective observational cohort study

Sogbodjor,

Razavi,

Williams

et al. 2024

Anaesthesia

View full text Add to dashboard Cite

SummaryAppendicectomy is a common procedure in children with a low risk of mortality, however, complication rates and risk factors are largely unknown. This study aimed to characterise the incidence and epidemiology of postoperative complications in children undergoing appendicectomy in the UK. This multicentre prospective observational cohort study, which included children aged 1–16 y who underwent surgery for suspected appendicitis, was conducted between November 2019 and January 2022. The primary outcome was 30‐day postoperative morbidity. Data collected included: patient characteristics; comorbidities; and physiological status. Multivariable regression analysis was used to identify independent risk factors for poor outcomes. Data from 2799 children recruited from 80 hospitals were analysed, of which 185 (7%) developed postoperative complications. Children from black and ‘other’ minority ethnic groups were at significantly higher risk of poor outcomes: OR (95%CI) 4.13 (1.87–9.08), p < 0.001 and 2.08 (1.12–3.87), p = 0.021, respectively. This finding was independent of socio‐economic status and type of appendicitis found on histology. Other risk factors for complications included: ASA physical status ≥ 3 (OR (95%CI) 4.05 (1.70–9.67), p = 0.002); raised C‐reactive protein (OR 95%CI 1.01 (1.00–1.01), p < 0.001); pyrexia (OR (95%CI) 1.77(1.20–2.63), p = 0.004); and peri‐operative oxygen supplementation (OR (95%CI) 4.20 (1.44–12.24), p = 0.009). In the UK NHS, which is a universally accessible healthcare system, ethnicity, but not socio‐economic status, was associated with an increased risk of postoperative complications in children having surgery for acute appendicitis. Further evaluations and interventions are required to address this health inequality in keeping with NHS and international priorities.

show abstract

“…Several articles demonstrated that the COVID-19 pandemic had a serious impact on pediatric surgery services. [18,19,[31][32][33][34] The overall influence on pediatric surgery activity, as well as the impact on the specific type of surgical procedures, including elective and outpatient services, were analyzed. [35][36][37] In many hospitals, elective surgeries were temporarily suspended to ensure adequate hospital capacity to respond to the rapid spikes in COVID-19 cases.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

Filip,

Avramia,

Terteliu-Baitan

et al. 2023

Medicine

View full text Add to dashboard Cite

Rationale: The COVID-19 pandemic had a dramatic effect on various health systems in terms of admissions and outcomes, including pediatric surgery activity. The aim of this paper was to analyze the outcome of SARS-CoV-2-positive patients admitted to our department during the regional COVID-19 pandemic in North-Eastern Romania. We also evaluated the changes generated in our daily practice by the COVID-19 pandemic and the dynamic response to this major challenge. Patient concerns: The patients presented with symptoms related to their primary diagnosis: local pain and deformity in case of fractures; pain, swelling, and erythema in case of abscess; pain and decreased range of motion (ROM) in case of intolerance to metal implants. Other specific concerns are mentioned on an individual basis. Diagnoses: Eighteen patients (of which 4 had acute appendicitis and were included in a previous article), representing 1.18% of the total number of admissions, tested positive for SARS-CoV-2. There were 4 patients with fractures, 3 patients with soft tissue abscess or cellulitis, 2 patients with intolerance to metal implants, 1 patient with facial burn, 1 patient with thumb laceration, 1 patient with liver trauma, 1 patient with undescende testis, and 1 patient with symptomatic inguinal hernia, respectively. Boys represented 11/ 14 (78.57%) of the cases. The mean age of the patients was 9 years 11 months. There were only mild COVID-19 cases. Interventions: Surgery was performed in 13/ 14 (95.71%) of cases. The fractures were treated with open reduction internal fixation (ORIF); incision and drainage (I & D) were performed in case of soft tissue abscess; the metal implants were removed in case of local intolerance. Other conditions (burn, inguinal hernia, undescended testis, skin laceration) were treated specifically. Only 1 patient with liver laceration was treated conservatively under close hemodynamic monitoring. Outcomes: The mean length of stay (LoS) was 2.71 days. The infection with the SARS-CoV-2 virus had no deleterious effect on the surgical outcome among the 14 patients included in the study. There were no surgical complications during admission and no patient returned for late complications related to their primary disease or SARS-CoV-2 infection. Lessons: The SARS-CoV-2 infection had no significant influence on the outcome of pediatric surgical cases included in the study. We noticed a significant (31.54%) decrease in the number of admissions compared to the previous 2-year interval before the COVID-19 pandemic. Fast and adequate adjustment of the daily activity imposed by the COVID-19 pandemic was feasible and may be used in the future should similar epidemiological emergencies occur.

show abstract

Pediatric appendicitis in the time of the COVID‐19 pandemic: A retrospective chart review

Cited by 9 publications

References 23 publications

A critical appraisal on the treatment of acute appendicitis in pediatric population during the COVID-19 pandemic

A critical appraisal on the treatment of acute appendicitis in pediatric population during the COVID-19 pandemic

Risk factors for complications after emergency surgery for paediatric appendicitis: a national prospective observational cohort study

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

Contact Info

Product

Resources

About