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Article ; Online: Paediatric appendicitis during the COVID-19 pandemic.

Sheath, Chloe / Abdelrahman, Mohamed / MacCormick, Andrew / Chan, David

2021 Volume 57, Issue 7, Page(s) 986–989

Abstract: ... presenting later during COVID-19, paediatric patients with appendicitis were treated expediently with good ... higher during the COVID-19 pandemic (24% vs. 10%, P = 0.03). They presented later (3 days vs. 1 day, P ... with none in the COVID-19 group. The proportion of patients diagnosed with appendicitis was significantly ...

Abstract	Aim: The repercussions of the pandemic on patients without COVID-19 have been well documented. Although there is evidence that adult patients present later with complicated appendicitis, the impact on the paediatric population is unknown. Therefore, the aim of this study was to assess the impact of the COVID-19 pandemic on the presentation and management of paediatric appendicitis. Methods: Data from consecutive paediatric patients admitted with right iliac fossa pain to a teaching hospital from 1 March 2020 until 30 June 2020 (COVID-19) were compared with patients admitted from 1 March 2019 until 30 June 2019 (control). Results: One hundred and seventy-two patients were admitted with right iliac fossa pain (control = 97, COVID-19 = 75). Seven patients had a normal diagnostic laparoscopy in the control group compared with none in the COVID-19 group. The proportion of patients diagnosed with appendicitis was significantly higher during the COVID-19 pandemic (24% vs. 10%, P = 0.03). They presented later (3 days vs. 1 day, P < 0.01) with higher inflammatory markers (white cell count 15.8 vs. 13.2 × 10 Conclusion: Despite presenting later during COVID-19, paediatric patients with appendicitis were treated expediently with good outcomes.
MeSH term(s)	Adult ; Appendectomy ; Appendicitis/diagnosis ; Appendicitis/epidemiology ; Appendicitis/surgery ; COVID-19 ; Child ; Humans ; Pandemics ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2021-02-01
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1024476-1
ISSN	1440-1754 ; 1034-4810
ISSN (online)	1440-1754
ISSN	1034-4810
DOI	10.1111/jpc.15359
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Article ; Online: Paediatric Appendicitis Management During the COVID-19 Pandemic

Oktay Ulusoy / Osman Zeki Karakuş / Oğuz Ateş / Efil Aydın / Gülce Hakgüder / Mustafa Olguner / Feza Miraç Akgür

Journal of Pediatric Emergency and Intensive Care Medicine, Vol 8, Iss 2, Pp 109-

What Has Changed?

2021 Volume 113

Abstract: ... increased during the same period. The COVID-19 pandemic caused some changes in our approach to paediatric ... the pandemic period (p=0.017).Conclusion:During the COVID-19 pandemic, fewer patients presented ... disease-2019 (COVID-19) pandemic is appendicitis, as it was before. This study aimed to evaluate clinical ...

Abstract	Introduction:The most common surgical emergency in the paediatric group during the coronavirus disease-2019 (COVID-19) pandemic is appendicitis, as it was before. This study aimed to evaluate clinical differences of paediatric appendicitis cases and changes in the management strategy between the pandemic and non-pandemic period.Methods:Cases during the non-pandemic period (March-July 2019) and pandemic period (March-July 2020) were analysed. Demographic data, duration of symptoms, physical examination, laboratory and radiological findings, paediatric appendicitis score (PAS), operative techniques, medical treatment, complications and hospital stay were evaluated retrospectively.Results:This study enrolled 70 patients during the non-pandemic period and 48 patients during the pandemic period. Duration of symptoms was significantly prolonged (p<0.001) and PAS was significantly increased during the pandemic period (p=0.001). Abdominopelvic ultrasonography detected abscess formation in one (1.4%) patient and 10 (20.8%) patients during the non-pandemic period and pandemic period, respectively. Complicated appendicitis was significantly higher (p=0.025) and the hospital stay were significantly longer during the pandemic period (p=0.017).Conclusion:During the COVID-19 pandemic, fewer patients presented to the paediatric emergency department with suspected appendicitis. Complicated appendicitis cases and hospital stay increased during the same period. The COVID-19 pandemic caused some changes in our approach to paediatric appendicitis cases such as the effective use of personal protective equipment, PAS scoring system and abdominopelvic ultrasonography.
Keywords	laparoscopic appendectomy ; covid-19 ; appendicitis ; paediatric ; Medicine ; R ; Pediatrics ; RJ1-570 ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Subject code	630
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Galenos Yayinevi
Document type	Article ; Online
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Article ; Online: Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic.

Snapiri, Ori / Rosenberg Danziger, Chen / Krause, Irit / Kravarusic, Dragan / Yulevich, Alon / Balla, Uri / Bilavsky, Efraim

Acta paediatrica (Oslo, Norway : 1992)

2020 Volume 109, Issue 8, Page(s) 1672–1676

Abstract: ... with complicated appendicitis. Main reasons for the delayed diagnosis during the COVID-19 era were parental concern ... from three paediatric surgical wards. Comparison between complicated appendicitis rates in the COVID-19 era ... telemedicine use and insufficient evaluation. Higher complication rates were found during the COVID-19 era ...

Abstract	Aim: To present seven paediatric patients with appendicitis, all with late diagnosis resulting from different aspects of the fear from the current global COVID-19 pandemic. Methods: Cases were collected from three paediatric surgical wards. Comparison between complicated appendicitis rates in the COVID-19 era and similar period in previous year was performed. Results: All seven children presented with complicated appendicitis. Main reasons for the delayed diagnosis during the COVID-19 era were parental concern, telemedicine use and insufficient evaluation. Higher complication rates were found during the COVID-19 era compared to similar period in previous year (22% vs 11%, P-value .06). Conclusion: The fear from COVID-19 pandemic may result in delayed diagnosis and higher complication rates in common paediatric medical conditions. We believe caregivers and healthcare providers should not withhold necessary medical care since delay in diagnosis and treatment in these routinely seen medical emergencies may become as big of a threat as COVID-19 itself.
MeSH term(s)	Adolescent ; Appendicitis/diagnosis ; COVID-19 ; Child ; Child, Preschool ; Coronavirus Infections/epidemiology ; Coronavirus Infections/psychology ; Delayed Diagnosis ; Fear ; Female ; Humans ; Israel/epidemiology ; Male ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/psychology
Keywords	covid19
Language	English
Publishing date	2020-06-08
Publishing country	Norway
Document type	Case Reports ; Journal Article
ZDB-ID	203487-6
ISSN	1651-2227 ; 0365-1436 ; 0803-5253
ISSN (online)	1651-2227
ISSN	0365-1436 ; 0803-5253
DOI	10.1111/apa.15376
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Article ; Online: Investigation of Serum Interleukin 6, High-Sensitivity C-Reactive Protein and White Blood Cell Levels during the Diagnosis and Treatment of Paediatric Appendicitis Patients Before and during the COVID-19 Pandemic.

Gürünlüoglu, Kubilay / Zararsiz, Gökmen / Aslan, Mehmet / Akbas, Sedat / Tekin, Mehmet / Gürünlüoglu, Semra / Bag, Harika Gözükara / Cin, Ecem Serbest / Macit, Bengü / Demircan, Mehmet

African journal of paediatric surgery : AJPS

2023 Volume 20, Issue 2, Page(s) 130–137

Abstract: ... of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times ... 19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients ... 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission ...

Abstract	Introduction: In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients. Materials and methods: A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared. Results: WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group. Conclusions: Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.
MeSH term(s)	Humans ; Child ; C-Reactive Protein/analysis ; C-Reactive Protein/metabolism ; Interleukin-6 ; Appendicitis/diagnosis ; Appendicitis/surgery ; Pandemics ; COVID-19 ; Leukocytes/chemistry ; Leukocytes/metabolism ; Appendectomy ; Retrospective Studies ; COVID-19 Testing
Chemical Substances	C-Reactive Protein (9007-41-4) ; Interleukin-6
Language	English
Publishing date	2023-03-23
Publishing country	India
Document type	Journal Article
ZDB-ID	2392865-7
ISSN	0974-5998 ; 0974-5998
ISSN (online)	0974-5998
ISSN	0974-5998
DOI	10.4103/ajps.ajps_128_21
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Article: Delayed diagnosis of paediatric appendicitis during the COVID-19 pandemic

Snapiri, Ori / Rosenberg Danziger, Chen / Krause, Irit / Kravarusic, Dragan / Yulevich, Alon / Balla, Uri / Bilavsky, Efraim

Acta Paediatr

Abstract	AIM: To present seven paediatric patients with appendicitis, all with late diagnosis resulting from different aspects of the fear from the current global COVID-19 pandemic. METHODS: Cases were collected from three paediatric surgical wards. Comparison between complicated appendicitis rates in the COVID-19 era and similar period in previous year was performed. RESULTS: All seven children presented with complicated appendicitis. Main reasons for the delayed diagnosis during the COVID-19 era were parental concern, telemedicine use and insufficient evaluation. Higher complication rates were found during the COVID-19 era compared to similar period in previous year (22% vs 11%, P-value .06). CONCLUSION: The fear from COVID-19 pandemic may result in delayed diagnosis and higher complication rates in common paediatric medical conditions. We believe caregivers and healthcare providers should not withhold necessary medical care since delay in diagnosis and treatment in these routinely seen medical emergencies may become as big of a threat as COVID-19 itself.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #381823
Database	COVID19

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Article ; Online: Delayed diagnosis of paediatric appendicitis during the COVID‐19 pandemic

Snapiri, Ori / Rosenberg Danziger, Chen / Krause, Irit / Kravarusic, Dragan / Yulevich, Alon / Balla, Uri / Bilavsky, Efraim

Acta Paediatrica

2020 Volume 109, Issue 8, Page(s) 1672–1676

Keywords	Pediatrics, Perinatology, and Child Health ; General Medicine ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ISSN	0803-5253
DOI	10.1111/apa.15376
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Article ; Online: Impact of COVID-19 on acute appendicitis presentation, management and pathology findings in adult and paediatric populations.

Johnston, Dorothy B / Coleman, Helen G / Colvin, David / Lawther, Suzanne / Loughrey, Maurice B

PloS one

2024 Volume 19, Issue 4, Page(s) e0300357

Abstract: ... in COVID-19 Year 1 compared with pre-pandemic. No absolute increase in perforated acute appendicitis cases ... Background: We investigated the impact of the COVID-19 pandemic on trends of presentation ... the pandemic. When comparing COVID-19 Year 1 with pre-pandemic, fewer patients presented with <24 hours ...

Abstract	Background: We investigated the impact of the COVID-19 pandemic on trends of presentation, management and pathology findings in patients who underwent an appendicectomy for suspected acute appendicitis. Method: The retrospective study reviewed patients (n = 939 adults and n = 329 children) who had an appendicectomy performed for suspected acute appendicitis and histopathology assessment in the Belfast Health and Social Care Trust, Northern Ireland. Pre-COVID-19 (March 2019 to February 2020) and COVID-19 Year 1 (March 2020 to February 2021) data were compared. Chi-squared tests were applied to compare timeframes. Results: 513 adult appendicectomies were performed in the immediate year pre-COVID-19, compared to 426 in COVID-19 Year 1, representing a 17% reduction. No such reduction was seen within the paediatric population, likely related to a change in regional paediatric referral criteria during the pandemic. When comparing COVID-19 Year 1 with pre-pandemic, fewer patients presented with <24 hours of symptoms (45% v 53%, p = 0.005), and there was greater use of pre-operative computed tomography imaging in adults (63.2% v 48.7%, p<0.001). Fewer adult and paediatric cases of simple acute appendicitis and non-diagnostic specimens, with relative increased proportions of perforated acute appendicitis, were observed in COVID-19 Year 1 compared with pre-pandemic. No absolute increase in perforated acute appendicitis cases was observed in adults. Conclusion: Year 1 of the COVID-19 pandemic was associated with delayed presentation of acute appendicitis in adults and children. In adults, an overall reduction in appendicectomy operations, increased use of pre-operative diagnostic imaging, and fewer specimens showing simple acute appendicitis or non-diagnostic features, collectively support appropriate restriction of surgery for those patients with a more certain acute appendicitis diagnosis.
MeSH term(s)	Adult ; Humans ; Child ; Appendicitis/surgery ; Retrospective Studies ; Pandemics ; COVID-19/epidemiology ; Appendectomy ; Acute Disease
Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0300357
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Article: We can reduce negative paediatric appendicectomy rate: A cohort study.

Patel, Maitreyi / Thomas, Joel Joy / Sarwary, Haschmatullah

Annals of medicine and surgery (2012)

2021 Volume 71, Page(s) 102901

Abstract: ... appendicectomy during the COVID-19 pandemic and 35 patients during 2019.Overall 17.39% patients underwent ... number of complicated appendicitis during the pandemic did not translate to worse clinical outcomes. ... would have undergone surgery. Hence, the negative appendicectomy rate during the pandemic should have ...

Abstract	Background: Appendicitis accounts for the most frequent surgical emergencies in childhood. The guidance from the Royal College of Surgeons and poor post operative outcomes in surgical patients during the pandemic, it would be expected that only children who had clinical signs of appendicitis and were unwell, would have undergone surgery. Hence, the negative appendicectomy rate during the pandemic should have decreased.The aim of this retrospective study was to assess the rate of negative appendicectomy amongst children <16 years of age during the first wave of the pandemic, from the announcement of the lockdown and determine if there was a true difference by comparing the rate with the same time period in 2019. Material and methods: Data of all children aged<16 years who were operated for appendicitis between 23/3/2020 and 30/06/2020 was collected retrospectively and compared with that of children operated during the same time period in 2019 for the rate of negative appendicectomy.Data were analysed using the two-tailed Results: Twenty three paediatric patients presenting with acute appendicitis underwent appendicectomy during the COVID-19 pandemic and 35 patients during 2019.Overall 17.39% patients underwent laparoscopic appendicectomy in 2020 while 54.29% in 2019. The negative appendicectomy rate was zero during the pandemic while it was 17.14% in 2019. There was no difference in the median length of hospital stay during the two time periods. There was no significant difference in complication or re-admission rate. Conclusion: This study has the lowest reported incidence of negative appendicectomy rate during the pandemic following wider use of pre operative imaging and early senior involvement in decision making. The increased number of complicated appendicitis during the pandemic did not translate to worse clinical outcomes.
Language	English
Publishing date	2021-10-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1016/j.amsu.2021.102901
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Article ; Online: Prospective study of laparoscopic management of appendicitis during the COVID pandemic in a single paediatric centre.

Dass, Dipankar / Hotonu, Sesi / McHoney, Merrill / Munro, Fraser

African journal of paediatric surgery : AJPS

2023 Volume 20, Issue 1, Page(s) 40–45

Abstract: ... in the incidence of complicated appendicitis, complications of surgery or length of stay during the COVID-19 ... This study analyses and describes the impact of the COVID-19 pandemic on the management of appendicitis ... of appendicitis during the pandemic.: Level of evidence: III, treatment. ...

Abstract	Background: The coronavirus (COVID-19) pandemic affected the presentation of many conditions. This study analyses and describes the impact of the COVID-19 pandemic on the management of appendicitis in children and the role of laparoscopy. Materials and methods: We performed a prospective (during the pandemic) and retrospective (historic control) review of the management of appendicitis in a tertiary paediatric surgical unit. Preoperative data, operative findings and patient outcomes were compared between groups to identify differences between the study periods and to identify any factors predictive of outcomes. Results: Sixty-two patients were identified in the pre-pandemic cohort, 72 in the pandemic cohort. There was no significant difference in patient demographics, length of admission or time between admission and surgery between groups. There was however a significantly longer time to presentation to hospital in the pandemic group. Clinical outcomes were comparable between the two groups, with no difference in the presence of surgical complications or histologically advanced appendicitis between the two groups. Laparoscopic surgery was safely used to manage appendicitis in the pandemic cohort through utilisation of a COVID-19 pathway that included guidance on testing, and use of personal protective equipment (PPE). Conservative management in the pandemic cohort was reserved for patients with appendicitis with the presence of mass formation. Conclusion: Despite a delayed presentation to hospital, there was no rise in the incidence of complicated appendicitis, complications of surgery or length of stay during the COVID-19 pandemic. Laparoscopic appendicectomy was also shown to be a safe and effective standard for the management of appendicitis during the pandemic. Level of evidence: III, treatment.
MeSH term(s)	Child ; Humans ; Prospective Studies ; COVID-19/epidemiology ; Appendicitis/epidemiology ; Appendicitis/surgery ; Pandemics ; Retrospective Studies ; Laparoscopy
Language	English
Publishing date	2023-02-10
Publishing country	India
Document type	Journal Article
ZDB-ID	2392865-7
ISSN	0974-5998 ; 0974-5998
ISSN (online)	0974-5998
ISSN	0974-5998
DOI	10.4103/ajps.ajps_181_21
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Article ; Online: Impact of COVID-19 Pandemic on Paediatric Appendicitis at a Tertiary Care Paediatric Hospital in New Delhi

Mamta Sengar / Chhabi R Gupta / Pritesh Maheshwari / Niyaz Khan / Shefalika Sharma

Journal of Clinical and Diagnostic Research, Vol 16, Iss 4, Pp PC21-PC

A Retrospective Study

2022 Volume 23

Abstract: ... of patients presenting with AA and the symptomatology during COVID-19 pandemic. ... Appendicitis (AA). Aim: To assess the impact of COVID-19 on paediatric Acute Appendicities patients ... 19 (COVID-19) pandemic. Measures taken to curtail the spread of Severe Acute Respiratory Syndrome ...

Abstract	Introduction: Across the globe the healthcare system was severely affected by Coronavirus Disease-19 (COVID-19) pandemic. Measures taken to curtail the spread of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) virus have severely affected the paediatric patients presenting with Acute Appendicitis (AA). Aim: To assess the impact of COVID-19 on paediatric Acute Appendicities patients at tertiary care center in New Delhi. Materials and Methods: This retrospective study was conducted at Chacha Nehru Bal Chikitsalaya, New Delhi. Patient demographics, symptomatology including delay in presentation to hospital, haematological, intraoperative findings and complications of all paediatric AA patients who underwent appendectomy from 23rd March 2020 to 22nd July 2020 (Pandemic Group- PG group) were recorded. Patients presenting in corresponding time period in the year 2019 was also compared {Non Pandemic Group (NPG) group}. Group comparisons for continuously distributed data were made using Independent sample t-test. For non normally distributed data, non parametric tests in the form of Wilcoxon test was used. Chi-squared test was used for group comparisons for categorical data. Results: A total of 72 patients were included with 39 in NPG and 33 in PG group, respectively. There were no significant differences between the two groups in terms of age (p-value=0.759) and sex distribution (p-value=0.93). Patients in PG group had higher leukocyte counts as compared to NPG group (16748.48±7744.08 vs 12510.26±7736.58, p-value <0.007). There was no significant difference in delay in presentation, symptomatology, duration of hospital stay and postoperative complications rate between the two groups. Conclusion: There has been no significant change in the number of patients presenting with AA and the symptomatology during COVID-19 pandemic.
Keywords	acute appendicitis ; children ; coronavirus disease-19 ; severe acute respiratory syndrome coronavirus-2 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
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