What has changed in children’s appendicitis during the COVID-19 pandemic?

BACKGROUND: The present study aimed to investigate the changes in the course of acute appendicitis during the pandemic period by comparing the cases treated during the coronavirus disease 2019 (COVID-19) pandemic with those in the pre-pandemic period.
METHODS: The study was conducted with 601 children aged 1–18 years who were operated for acute appendicitis between May 1, 2019, and February 29, 2020 (Group I) and between March 1 and December 31, 2020 (Group II). The demographic and disease characteristics as well as the treatment processes were compared between the groups.
RESULTS: It was found that 59.1% (n=355) of the cases included in the study were in Group I and 40.9% (n=246) were in Group II. During the pandemic period; due to the concerns of families about contracting a contagious disease for both themselves and their children, and warnings by health professionals and government officials that they should not leave their homes and not come to the hospital unless there is an emergency, the time to apply to the hospital has been extended. Before the pandemic, 20.3% of the patients presented to the hospital on the 1st day of their complaints, where during the pandemic, only 2% of the patients reported to the hospital on the 1st day, and 15% presented after 4 days or more. As a result, the rate of perforated appendicitis, which was formerly 10.4%, increased to 24.8% during the pandemic period (p<0.01). During the pandemic, we operated on four patients with positive COVID-19 test results. There were no complications related to COVID-19 and surgery in our patients.
CONCLUSION: Concern of the current pandemic resulted in late presentation to the hospital, increase in the number of perforated appendicitis, and prolonged hospital stay.

COVID-19 salgýnýnda çocuk apandisitlerinde ne deðiþti?

AMAÇ: COVID-19 salgýný sýrasýnda akut apandisitin yönetimi ile ilgili çocuk yaþ grubundaki çalýþmalar olgu sunumlarý ve küçük hasta gruplarý ile sýnýrlýdýr. Bu çalýþmanýn amacý, COVID-19 salgýný süresince akut apandisit nedeniyle tedavi ettiðimiz olgularý salgýn öncesi dönemdeki olgularla karþý-laþtýrarak salgýn döneminde akut apandisitin seyrinde ne gibi deðiþiklikler olduðunu araþtýrmaktýr.
GEREÇ VE YÖNTEM: 1 Mayýs 2019–29 Þubat 2020 (Grup I) ve 1 Mart–31 Aralýk 2020 (Grup II) tarihleri arasýnda akut apandisit nedeniyle ameliyat edilen 1–18 yaþ arasýnda toplam 601 çocuk üzerinde gerçekleþtirildi. Grup I ve Grup II’de yer alan hastalarýn demografik ve hastalýk özellikleri ile tedavi sürecine iliþkin özellikleri karþýlaþtýrýldý.
BULGULAR: Çalýþmaya alýnan olgularýn %59.1’i (n=355) Grup I, %40.9’u (n=246) Grup II’de yer almaktadýr. Salgýn döneminde; ailelerin hem kendileri hem de çocuklarý için taþýdýðý bulaþýcý hastalýða yakalanma endiþesi, saðlýk profesyonelleri ve hükümet yetkilileri tarafýndan yapýlan acil bir durum olmadýðý sürece evlerinden çýkmamalarý ve hastaneye gelmemeleri yönündeki uyarýlar nedeniyle hastaneye baþvuru süreleri uzamýþtýr. Salgýn öncesi hastalarýn %20.3’ü þikayetlerinin baþladýðý ilk gün hastaneye baþvururken salgýn sürecinde hastalarýn sadece %2’si ilk gün, %15’i ise dört gün ve daha uzun süre sonra hastaneye baþvurmuþtur. Bu durumun sonucu olarak salgýn öncesi %10.4 olan perfore apandisit oraný salgýn döneminde %24.8’e yükselmiþtir (p<0.01). Salgýn döneminde COVID-19 test sonucu pozitif olan dört hastamýzý ameliyat ettik. Hastalarýmýzda COVID-19 ve ameliyata baðlý komplikasyon geliþmedi.
TARTIÞMA: Mevcut küresel salgýndan duyulan korku çocuklarýn hastaneye baþvurma süresinin uzamasýna, perfore apandisit sayýsýnýn artýþýna ve hastanede kalýþ süresinin uzamasýna neden olmuþtur.