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2020 ; 93
(2
): 118-122
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Influence of the coronavirus 2 (SARS-Cov-2) pandemic on acute appendicitis
#MMPMID32837965
Velayos M
; Muñoz-Serrano AJ
; Estefanía-Fernández K
; Sarmiento Caldas MC
; Moratilla Lapeña L
; López-Santamaría M
; López-Gutiérrez JC
An Pediatr (Engl Ed)
2020[Aug]; 93
(2
): 118-122
PMID32837965
show ga
INTRODUCTION: Acute appendicitis (AA) is the most common abdominal surgical
emergency. No specific studies have been found that evaluate the impact of the
coronavirus 2 (SARS-Cov-2) pandemic on AA and its surgical management. An
analysis was made on the influence of this new pathology on the clinical course
of AA. MATERIAL AND METHODS: Retrospective observational study was conducted on
patients operated on for AA from January to April 2020. They were classified
according to the time of the appendectomy, before the declaration of the state of
alarm (Pre-COVID-19), and after its declaration (Post-COVID-19) in Spain, one the
most affected countries in the world. An evaluation was made of demographic
variables, duration of symptoms, type of appendicitis, surgical time, hospital
stay, and postoperative complications. RESULTS: The study included 66 patients
(41 Pre-COVID-19; 25 Post-COVID-19) with mean age of 10.7?±?3 and 9.3?±?3.1;
P?=?.073, respectively. Fever was found in a higher number of post-COVID-19
patients (52 vs 19.5%; P?=?.013), as well as a higher CRP (72.7?±?96.2 vs
31.3?±?36.2?mg/dL; P?=?.042). This group presented with a higher proportion of
complicated appendicitis when compared to Pre-COVID-19 (32 vs 7.3%; P?=?.015).
The mean hospital stay was longer in the Post-COVID-19 group (5.6?±?5.9 vs
3.2?±?4.3 days; P?=?.041). No differences were found in the time of onset of
symptoms or surgical time. CONCLUSIONS: The SARS-Cov-2 pandemic influenced the
time of diagnosis of appendicitis, as well as its course, and mean hospital stay.
Peritonitis was more frequently seen. As a result of the significant
circumstances, delaying diagnosis and treatment of AA during SARS-Cov-2 pandemic,
inappropriate management of this common surgical disorder has been noticed.