Frequency of complicated appendicitis in the pediatric population during the COVID-19 pandemic

Abstract

INTRODUCTION: Appendicitis is the most frequent surgical emergency in pediatrics. Complicated forms
are related to a delay in medical care and/or diagnosis. Throughout the COVID-19 pandemic, a decrease in
hospital consultations was observed for fear of becoming infected and breaking isolation. This generated a
late diagnosis with complications in certain pathologies such as appendicitis.
OBJECTIVE: To compare the frequency of complicated appendicitis during the COVID-19 pandemic
(pandemic group) with a period prior to it (pre-pandemic group) to determine if there was an increase in
these. To analyze the demographic data, intraoperative classification of appendicitis, laboratory values,
hospitalization time, post-surgical complications.
MATERIAL AND METHODS: This is an observational, retrospective, analytical study, carried out at the
Reina Fabiola University Clinic, during the month of June 2022. All hospitalized patients under 16 years
of age with a diagnosis of appendicitis were included. A descriptive analysis of the variables was performed.
The chi square test was used for qualitative data and Student's t test or Mann Whitney test for quantitative
data.
RESULTS: We included 89 patients were studied, 42 corresponded to the time of the pandemic and 47 to
the pre-pandemic group. In both groups the male sex predominated (55%). The mean age and standard
deviation (SD) of pre-pandemic patients was 10 (± 3) vs 9 (± 3) years during the pandemic (p=0.04). No
differences were observed before and during the pandemic in the time from evolution to surgery, with a
mean (SD) of 36 (±20) vs 32 (±18) h (p=0.85), on days of hospitalization. 3 (±3.8) vs 4.5 (±3.8) days
(p=0.84), in the frequency of complicated appendicitis %38 vs. %45 (p=0.88) nor in the frequency of postsurgical complications %17 vs. %24 (p =0.46). No differences were observed before and during the
pandemic in CRP values with a mean (SD) of 26.5(±51) vs 23(±48) mg/dl (p=0.38), leukocytes
13350(±5000) thousands/ul vs 14800(±5500) thousands/ul (p=0.26) and percentage of polymorphonuclear
neutrophils %77.5(±11) vs %81(±11) (p=0.27).
CONCLUSIONS: During the pandemic, there was no significant increase in the frequency of patients with
complicated appendicitis, nor in the days of hospitalization, hours of evolution until appendectomy or postsurgical complications, in relation to laboratory values, there were also no differences between CRP, white
blood cell count and percentage of neutrophils.