Abstract
Background: Appendicitis is a common acute surgical condition in the pediatric population. With the rise of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many efforts have been made to understand the association of this virus with other disease entities. However, the association of acute appendicitis and SARS-CoV-2 infection in children has not been well established. Few cases have been described in the literature with different hypotheses attempting to link the two entities. This highlights the need to be aware of such possible associations to achieve proper diagnosis and management and avoid complications. Case Report: In this report, we describe the case of a seven-year-old boy who presented to our institution with uncomplicated appendicitis. The child was found to have SARS-CoV-2 infection on routine hospital testing. His condition deteriorated within hours, and he progressed from uncomplicated to complicated appendicitis. The child underwent surgical management followed by further medical management until he recovered. He had a smooth recovery and experienced no complications. Conclusion: There is still no definite explanation concerning the effect of COVID-19 on appendicitis. Clinicians should be aware of the possibility of acute appendicitis in the context of pediatric SARS-CoV-2 infection and anticipate a possible progression of the disease course triggered by the virus.
Highlights
Appendicitis is one of the most common acute surgical conditions in children [1]
We hereby discuss the case of a 7-year-old boy who presented to the emergency department with an acute abdomen, tested positive for SARS-CoV2, and was diagnosed with acute uncomplicated appendicitis that progressed rapidly to a complicated one
While healthcare centers might opt for the non-operative management of complicated appendicitis in hopes of decreasing transmission to healthcare providers, Bonadio et al report a greater length of hospital stay in children with perforated appendicitis who are managed non operatively, which justifies the preference for an open laparotomy over medical treatment during the pandemic [17]
Summary
There is still no clear evidence whether complicated appendicitis may be the result of direct infection of the SARS-CoV-2 virus targeting appendiceal tissues or if it is the result of an exaggerated immune response in COVID-19 positive patients or even due to the delay in diagnosis and management attributed to the ongoing pandemic. There is no evidence yet for the need to alter the management, clinicians should be aware of the possibility of acute appendicitis in the context of pediatric SARS-CoV-2 infection and anticipate a possible progression of the disease course triggered by the virus. For this reason, clinical and surgical approaches should not be delayed when clinically indicated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
