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.