Paediatric Appendicitis Management During the COVID-19 Pandemic: What Has Changed?

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.