Did the COVID-19 Pandemic Prolong the Time Till Diagnosis and Worsen Outcomes for Children with Acute Appendicitis?

Idilė Vansevičienė,Emilis Čekanauskas,Dalius Malcius,Aušra Lukošiūtė-Urbonienė,Vidmantas Barauskas,Danielė Bučinskaitė,Mindaugas Beržanskis

doi:10.3390/medicina57111234

Idilė Vansevičienė, Emilis Čekanauskas + Show 5 more

Open Access

https://doi.org/10.3390/medicina57111234

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Abstract

Background and Objectives: Our aim was to see if the COVID-19 pandemic led to an increase of time until diagnosis, operation, and time spent in Emergency room (ER), and if it resulted in more cases of complicated appendicitis and complication rates in children. Materials and Methods: We conducted a retrospective analysis of patients admitted to the Pediatric Surgery Department with acute appendicitis during a 4-month period of the first COVID-19 pandemic and compared it to the previous year data—the same 4-month period in 2019. Results: During the pandemic, the time spent in the ER until arriving at the department increased significantly 2.85 vs. 0.98 h p < 0.001, and the time spent in the department until the operation 5.31 vs. 2.66 h, p = 0.03. However, the time from the beginning of symptoms till ER, operation time and the length of stay at the hospital, as well as the overall time until operation did not differ and did not result in an increase of complicated appendicitis cases or postoperative complications. Conclusions: The COVID-19-implemented quarantine led to an increase of the time from the emergency room to the operating room by 4 h. This delay did not result in a higher rate of complicated appendicitis and complication rates, allowing for surgery to be postponed to daytime hours if needed.

Highlights

Acute appendicitis (AA) remains one of the most common surgical problems worldwide in the pediatric population, having a lifetime risk of 7–8% [1]
Three-hundred-and-seventy-five patients were admitted to the pediatric surgery department in 2020 from 16 March to 16 June during the first wave of COVID-19, 58 of which were treated for acute appendicitis
There was a lower number of total patients admitted to the hospital in 2020 in comparison to 2019 (375 vs. 815), having a 54% lower number of patients admitted to the pediatric surgery department due to restrictions of elective surgery during the lockdown period

Summary

Introduction

Acute appendicitis (AA) remains one of the most common surgical problems worldwide in the pediatric population, having a lifetime risk of 7–8% [1]. Our hypothesis was that the pandemic increased the time until patients received surgical treatment, and that this resulted in an increase of complicated cases of appendicitis and postoperative complications. Our aim was to see if the COVID-19 pandemic led to an increase of time until diagnosis, operation, and time spent in Emergency room (ER), and if it resulted in more cases of complicated appendicitis and complication rates in children. Conclusions: The COVID-19-implemented quarantine led to an increase of the time from the emergency room to the operating room by 4 h This delay did not result in a higher rate of complicated appendicitis and complication rates, allowing for surgery to be postponed to daytime hours if needed

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