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Pogorelić, Z. Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic. Encyclopedia. Available online: https://encyclopedia.pub/entry/17865 (accessed on 29 March 2024).
Pogorelić Z. Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic. Encyclopedia. Available at: https://encyclopedia.pub/entry/17865. Accessed March 29, 2024.
Pogorelić, Zenon. "Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic" Encyclopedia, https://encyclopedia.pub/entry/17865 (accessed March 29, 2024).
Pogorelić, Z. (2022, January 07). Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic. In Encyclopedia. https://encyclopedia.pub/entry/17865
Pogorelić, Zenon. "Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic." Encyclopedia. Web. 07 January, 2022.
Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic
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The Coronavirus Disease 2019 (COVID-19) pandemic has impacted volume, management strategies and patient outcomes of acute appendicitis. There is a significantly higher incidence of complicated appendicitis in children during the COVID-19 pandemic than in the pre-COVID-19 period. Additionally, a significantly higher proportion of children was managed via the NOM during the pandemic in comparison to the pre-pandemic period. 

acute appendicitis appendectomy Coronavirus Disease 2019 COVID-19 non-operative management

1. Introduction

Acute appendicitis is the most common condition in the pediatric population that leads to emergency abdominal surgery [1][2]. Although advanced diagnostic imaging is widely available, the initial diagnosis of appendicitis in children can be challenging, with rates of misdiagnosis reaching 100% in children aged two years or younger [3][4][5][6]. This has been attributed to nonspecific presentation and overlap of symptoms with other common childhood conditions such as mesenteric lymphadenitis, gastroenteritis, or Meckel’s diverticulitis. Clinical scores, such as Alvarado, appendicitis inflammatory response score, and pediatric appendicitis score have been developed to aid the diagnosis of acute appendicitis in children [3][4]. The diagnostic delay often leads to a higher incidence of complications, such as perforation. Perforation rates show an inverse relation to age, ranging from 47.3% in children five years of age, to 100% in children under two years of age [5][6]. Elevated inflammatory markers from blood or even hyponatremia and hyperbilirubinemia have been shown to assist in distinguishing between simple and perforated appendicitis [7][8][9]. Despite advances in medicine, especially in imaging diagnostics, acute appendicitis still in a certain percentage of patients remains unrecognized and mistreated in the initial stage of the disease [1][8][9].
In addition to all diagnostic challenges, the Coronavirus Disease 2019 (COVID-19) pandemic has become a new obstacle to overcome. The pandemic has disrupted the normal practice of economy, governance, and scientific and medical expertise [10]. Confinement measures, introduced in order to minimize the number of infected people, have had an impact on patients, medical procedures, and healthcare workers [11]. Many governing bodies have recommended the cancellation of elective surgical procedures during the pandemic, resulting in a major burden on healthcare systems [12]. A decline in admission rates for numerous medical and surgical conditions has been observed, possibly due to a generalized public fear of presenting to a hospital during the pandemic [13][14][15][16][17]. Despite the confinement measures, acute appendicitis does not quarantine [18]. The pandemic has impacted volume, diagnostic and management strategies, and patient outcomes of acute appendicitis [19][20]. A nationwide study in the United States found a significant decrease in acute appendicitis presentation, while two studies from Germany observed a decrease in the number of appendectomies during the lockdown [19][21][22]. Additionally, it was suggested that non-operative management (NOM) could be a safe alternative to surgery during the pandemic [23][24][25]. A study from Budapest suggests that a higher number of perforated appendices is in line with international trends, and shares no correlation with the COVID-19 pandemic [24]. In contrast, various studies have also demonstrated no significant differences in the rates of complicated appendicitis among children presenting during the pandemic versus the pre-pandemic period [19][20]. Due to these conflicting findings, there is no consensus statement regarding the incidence of complicated appendicitis among the children presenting during the pandemic.

2. Complicated Appendicitis during the COVID-19 Pandemic and Pre-Pandemic

A classification of complicated appendicitis is given when there is evidence of a perforated or gangrenous appendix, an intra-abdominal abscess, or fecal peritonitis, which often results in a longer length of stay and greater rates of morbidity and mortality. Overall, complicated appendicitis is more common in children, with rates as high as 30% [6][26]. One of the reasons for the higher incidence of complicated appendicitis in young patients is diagnostic delay. The diagnostic delay is partly due to unclear anamnesis and atypical clinical presentations found in young patients. Studies showed that appendicitis is a diagnostic challenge with 7–15% of cases presenting twice to the emergency department before diagnosis, resulting in an increase in the rate of complications [27][28][29]. The risk of perforation within 24 h of the onset of symptoms is substantial (7.7%), and it increases in a linear fashion with duration, especially with prehospital delay, moreso than with admitted children [30]. Socioeconomic factors, which are globally worsened by ongoing COVID-19 pandemic, are also important factor in delayed presentation of pediatric patients as seeking medical care is dependent upon parents’ knowledge of illness, transportation options, insurance status, and financial wellbeing [31][32]. Another reason for higher incidence of complicated appendicitis in young patients is misdiagnosis. Misdiagnosis is due to the fact that the classical clinical symptoms and laboratory findings that are common in older pediatric population are missing in the younger [4]. Patient age is tied closely to the stage of acute appendicitis, so the youngest patients present with more advanced stages of disease and are at greater risk of perforation, with recent study showing a significant increase of perforation in relation with age as follows: 100%  <  1 year; 100% 1–2 years; 83.3% 2–3 years; 71.4% 3–4 years; 78.6% 4–5 years and 47.3% of  5 years [6]. Studies also demonstrate that using various clinical methods (clinical exam, laboratory tests, imaging and clinical scores), the availability of which can be reduced during COVID-19 pandemic, is associated with a reduction in the negative appendectomy rate from 14% to 4%, with a slight reduction in the rate of perforated appendicitis [33].

The most accepted mode of treatment of acute appendicitis is appendectomy following fluid resuscitation, analgesia, and intravenous antibiotics. Laparoscopic appendectomy is the most common surgical option with known benefits of lesser incidence of postoperative ileus, a shorter hospital stays, reduced analgesic requirements, a reduced incidence of wound infection and less risk of subsequent adhesive bowel obstruction [1][34][35][36][37]. Intra-abdominal abscess rates are similar after laparoscopic and open appendectomy and are largely determined by whether the appendix is perforated or not [1][34][35][36][37]. Another option for treatment is NOM (conservative therapy) which can represent a feasible option for acute appendicitis, although complication-free treatment success rates are higher with surgical treatment [1]. NOM with antibiotics may fail during the primary hospitalization in about 8% of cases, and an additional 20% of patients might need a second hospitalization for recurrent appendicitis [38].

All of the aforementioned factors in diagnosis and treatment of pediatric appendicitis are being affected by the ongoing COVID-19 pandemic. Since it started in March of 2020, the COVID-19 pandemic represents significant global health threat, a political challenge and has severely affected human life and welfare [11][39]. Extensive measures, most significant being lockdowns, have been implemented to lower person-to-person transmission and to stop distribution of virus. In the beginning of the pandemic, lockdowns and “Staying home” were most common means to prevent transmission of the virus. During the COVID-19 pandemic elective surgical procedures were canceled in most centers. Surgical procedures were limited only for the care of urgent surgical patients [12][13][14][15][16][17][40][41]. These efforts to minimize unnecessary traffic through the healthcare facility resulted in a significant reduction in emergency department patient encounters [39][41].

There is a significantly higher incidence of complicated appendicitis among the children in pandemic group versus non-pandemic group. There is a significantly higher proportion of children managed via the NOM during the pandemic versus pre-pandemic period [42][43][44][45][46][47].

Significantly higher complicated appendicitis rates during the pandemic can be explained by multiple factors. Delayed presentation of pediatric patients, in general, and higher incidence of NOM during pandemic, are the most important ones. Socioeconomics and delay in time from admission to surgery because of pandemic protocols could be speculated as minor factors [48]. The risk of perforation and other complications increases in a linear fashion with duration of disease, especially with pre-hospital delay more than with admitted children. Several studies recorded longer prehospital delay in admission of acute appendicitis during the pandemic [9][42][49][44][50][46], while other studies showed no significant difference between pandemic and pre-pandemic delay of presentation [42][51][52][50][53][47]. Significant increases in delayed care for different medical emergencies, including pediatric surgical emergencies, during the COVID-19 pandemic period have been noted by the medical community and published in several reports [54]. The effects of the COVID-19 pandemic are recorded in other urgent pediatric surgery conditions such as testicular torsion, in which latest studies show significantly longer time from testicular torsion symptom onset to presentation during the pandemic and a significantly higher proportion of patients reported delaying care [17][55]. Recent studies show that the outbreak of the COVID-19 pandemic is associated with a delay in presentation of patients with most common medical emergencies such as acute ischemic stroke and delay of diagnosis of colorectal carcinomas, which will lead to a massive downstream impact on healthcare [56][57]. Delayed presentation can be explained by avoidance of unnecessary hospital visits in the absence of severe symptoms and reduced or delayed access to medical care due to parental fear of children’s exposure to COVID-19.

As per the findings from recent adult/pediatric studies, the patients developing appendicitis during the pandemic reach healthcare facilities on time (similar to the pre-pandemic period). Although an identical management algorithm of acute appendicitis was followed during the two time periods, more reliance on non-operative management was observed among the surgeons during the COVID-19 pandemic [58][59]. The main reasons for NOM were the risk of false negative testing and prevention of viral transmission to healthcare workers in the operating room as well as to minimize hospital resource utilization. Additionally, it could be speculated that more patients asked for non-surgical treatment strategies during the pandemic as compared with the cases before the outbreak, with the fear of hospital admission and acquiring the COVID-19 infection from the hospital.

Open surgery is suggested as a possible approach because of the shorter operation time and lower risk of COVID-19 transmission [60][61]. Widespread use of laparoscopic approach and surgeons not being familiar with open surgery could be a reason for higher incidence and more reliance on NOM during pandemic.

Fonseca et al. reported a 56% reduction in the number of appendectomies performed in pandemic group in comparison with pre-pandemic, and Percul et al. reported a reduction of 25% in total number of acute appendicitis cases [42][53]. It could be speculated that during COVID-19 pandemic, patients with mild or non-specific symptoms were not seeking medical care because of the concern about acquiring COVID-19 infection. The number of cases that resolved on their own or are treated with antibiotics prescribed by gatekeepers should also be considered. Confounding variables such as movement restrictions, difference between mild and strict lockdown restrictions, travel restrictions, limited resources, studies being researched mainly in tertiary centers, and other pandemic-induced changes should also be acknowledged [52]. Here additional research is needed and data from outpatient medical care needs to be researched.
There is a significantly higher number of complicated appendicitis during the COVID-19 pandemic compared with pre-COVID-19 period. Additionally, the study demonstrates an increase in NOM of appendicitis during the pandemic. Both outcomes are direct effect of the COVID-19 pandemic. Management of pediatric appendicitis during this pandemic must be evaluated individually for every hospital and its capacity for SARS-CoV-2 testing, laboratory tests, imaging options, bed, staff, emergency ward capacity and personal protective equipment capacity. Although appendectomy should not be impacted by restrictions on elective procedures several institutions, countries and professional associations recommend performing NOM for appendicitis during pandemic [62].
COVID-19 fundamentally changes the way emergency wards and hospitals function and deliver patient care. The overflow of COVID-19 patients and the effects of the pandemic on health systems, in general, influenced emergency and pediatric specialties wards, which condensed as both elective and emergency care across pediatric specialties decreased and many of these wards were converted to adult wards to accommodate the overflow of adult COVID-19 patients. There were numerous considerations and limitations to consider while delivering patient care, attempting to limit hospital stays while also limiting the number of operations. In conclusion, COVID-19 is a global pandemic, challenging healthcare systems worldwide. During these challenging times, we address the importance of a comprehensive evaluation, physical examination, appropriate and effective treatment in children suspected of having any surgical condition. Balance should be achieved between measures designed to end the pandemic and the appropriate care of pediatric population requiring surgical care.

References

  1. Stinger, M.D. Acute appendicitis. J. Paediatr. Child Health 2017, 53, 1071–1076.
  2. Glass, C.C.; Rangel, S.J. Overview and diagnosis of acute appendicitis in children. Semin. Pediatr. Surg. 2016, 25, 198–203.
  3. Pogorelić, Z.; Mihanović, J.; Ninčević, S.; Lukšić, B.; Elezović Baleović, S.; Polašek, O. Validity of appendicitis inflammatory response score in distinguishing perforated from non-perforated appendicitis in children. Children 2021, 8, 309.
  4. Pogorelić, Z.; Rak, S.; Mrklić, I.; Jurić, I. Prospective validation of Alvarado score and pediatric appendicitis score for the diagnosis of acute appendicitis in children. Pediatr. Emerg. Care 2015, 31, 164–168.
  5. Lounis, Y.; Hugo, J.; Demarche, M.; Seghaye, M.C. Influence of age on clinical presentation, diagnosis delay and outcome in pre-school children with acute appendicitis. BMC Pediatr. 2020, 20, 151.
  6. Pogorelić, Z.; Domjanović, J.; Jukić, M.; Peričić, T.P. Acute appendicitis in children younger than five years of age: Diagnostic challenge for pediatric surgeons. Surg. Infect. 2020, 21, 239–245.
  7. Miyauchi, H.; Okata, Y.; Hatakeyama, T.; Nakatani, T.; Nakai, Y.; Bitoh, Y. Analysis of predictive factors for perforated appendicitis in children. Pediatr. Int. 2020, 62, 711–715.
  8. Pogorelić, Z.; Lukšić, B.; Ninčević, S.; Lukšić, B.; Polašek, O. Hyponatremia as a predictor of perforated acute appendicitis in pediatric population: A prospective study. J. Pediatr. Surg. 2021, 56, 1816–1821.
  9. Pogorelić, Z.; Lukšić, A.M.; Mihanović, J.; Đikić, D.; Balta, V. Hyperbilirubinemia as an indicator of perforated acute appendicitis in pediatric population: A prospective study. Surg. Infect. 2021, 22, 1064–1071.
  10. Chakraborty, I.; Maity, P. COVID-19 outbreak: Migration, effects on society, global environment and prevention. Sci. Total Environ. 2020, 728, 138882.
  11. Dolić, M.; Antičević, V.; Dolić, K.; Pogorelić, Z. Questionnaire for assessing social contacts of nurses who worked with coronavirus patients during the first wave of the COVID-19 pandemic. Healthcare 2020, 9, 930.
  12. COVID Surg Collaborative. Elective surgery cancellations due to the COVID-19 pandemic: Global predictive modelling to inform surgical recovery plans. Br. J. Surg. 2020, 107, 1440–1449.
  13. Dong, C.T.; Liveris, A.; Lewis, E.R.; Mascharak, S.; Chao, E.; Reddy, S.H.; Teperman, S.H.; McNelis, J.; Stone, M.E., Jr. Do surgical emergencies stay at home? Observations from the first United States coronavirus epicenter. J. Trauma Acute Care Surg. 2021, 91, 241–246.
  14. Garcia, S.; Albaghdadi, M.S.; Meraj, P.M.; Schmidt, C.; Garberich, R.; Jaffer, F.A.; Dixon, S.; Rade, J.J.; Tannenbaum, M.; Chambers, J.; et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J. Am. Coll. Cardiol. 2020, 75, 2871–2872.
  15. Lange, S.J.; Ritchey, M.D.; Goodman, A.B.; Dias, T.; Twentyman, E.; Fuld, J.; Schieve, L.A.; Imperatore, G.; Benoit, S.R.; Kite-Powell, A.; et al. Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020. Morb. Mortal. Wkly. Rep. 2020, 69, 795–800.
  16. De Filippo, O.; D’Ascenzo, F.; Angelini, F.; Bocchino, P.P.; Conrotto, F.; Saglietto, A.; Secco, G.G.; Campo, G.; Gallone, G.; Verardi, R.; et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N. Engl. J. Med. 2020, 383, 88–89.
  17. Pogorelić, Z.; Milanović, K.; Veršić, A.B.; Pasini, M.; Divković, D.; Pavlović, O.; Lučev, J.; Žufić, V. Is there an increased incidence of orchiectomy in pediatric patients with acute testicular torsion during COVID-19 pandemic? A retrospective multicenter study. J. Pediatric Urol. 2021, 17, 479.e1–479.e6.
  18. Dreifuss, N.H.; Schlottmann, F.; Sadava, E.E.; Rotholtz, N.A. Acute appendicitis does not quarantine: Surgical outcomes of laparoscopic appendectomy in COVID-19 times. Br. J. Surg. 2020, 107, 368–369.
  19. Rosenthal, M.G.; Fakhry, S.M.; Morse, J.L.; Wyse, R.J.; Garland, J.M.; Duane, T.M.; Slivinski, A.; Wilson, N.Y.; Watts, D.D.; Shen, Y.; et al. Where did all the appendicitis go? Impact of the COVID-19 pandemic on volume, management, and outcomes of acute appendicitis in a nationwide, multicenter analysis. Ann. Surg. 2021, 2, e048.
  20. Ganesh, R.; Lucoq, J.; Ekpete, N.O.; Ul Ain, N.; Lim, S.K.; Alwash, A. Management of appendicitis during COVID-19 pandemic; short-term outcomes. Scott. Med. J. 2020, 65, 144–148.
  21. Maneck, M.; Günster, C.; Meyer, H.J.; Heidecke, C.D.; Rolle, U. Influence of COVID-19 confinement measures on appendectomies in Germany-a claims data analysis of 9797 patients. Langenbeck’s Arch. Surg. 2021, 406, 385–391.
  22. Willms, A.G.; Oldhafer, K.J.; Conze, S.; Thasler, W.E.; von Schassen, C.; Hauer, T.; Huber, T.; Germer, C.T.; Günster, S.; Bulian, D.R.; et al. Appendicitis during the COVID-19 lockdown: Results of a multicenter analysis in Germany. Langenbeck’s Arch. Surg. 2021, 406, 367–375.
  23. Emile, S.H.; Hamid, H.K.S.; Khan, S.M.; Davis, G.N. Rate of application and outcome of non-operative management of acute appendicitis in the setting of COVID-19: Systematic review and meta-analysis. J. Gastrointest. Surg. 2021, 25, 1905–1915.
  24. Fadgyas, B.; Garai, G.I.; Ringwald, Z. How COVID-19 pandemic influences paediatric acute appendicitis cases? Orv. Hetil. 2021, 162, 608–610.
  25. Pawelczyk, A.; Kowalska, M.; Tylicka, M.; Koper-Lenkiewicz, O.M.; Komarowska, M.D.; Hermanowicz, A.; Debek, W.; Matuszczak, E. Impact of the SARS-CoV-2 pandemic on the course and treatment of appendicitis in the pediatric population. Sci. Rep. 2021, 11, 23999.
  26. Pham, X.D.; Sullins, V.F.; Kim, D.Y.; Range, B.; Kaji, A.H.; de Virgilio, C.M.; Lee, S.L. Factors predictive of complicated appendicitis in children. J. Surg. Res. 2016, 206, 62–66.
  27. Reynolds, S.L. Missed appendicitis in a pediatric emergency department. Pediatr. Emerg. Care 1993, 9, 1–3.
  28. Nelson, D.S.; Bateman, B.; Bolte, R.G. Appendiceal perforation in children diagnosed in a pediatric emergency department. Pediatr. Emerg. Care 2000, 16, 233–237.
  29. Rothrock, S.G.; Skeoch, G.; Rush, J.J.; Johnson, N.E. Clinical features of misdiagnosed appendicitis in children. Ann. Emerg. Med. 1991, 20, 45–50.
  30. Narsule, C.K.; Kahle, E.J.; Kim, D.S.; Anderson, A.C.; Luks, F.I. Effect of delay in presentation on rate of perforation in children with appendicitis. Am. J. Emerg. Med. 2011, 29, 890–893.
  31. Bodnar, C.; Buss, R.; Somers, K.; Mokdad, A.; Van Arendonk, K.J. Association of neighborhood socioeconomic disadvantage with complicated appendicitis in children. J. Surg. Res. 2021, 265, 245–251.
  32. O’Toole, S.J.; Karamanoukian, H.L.; Allen, J.E.; Caty, M.G.; O’Toole, D.; Azizkhan, R.G.; Glick, P.L. Insurance-related differences in the presentation of pediatric appendicitis. J. Pediatr. Surg. 1996, 31, 1032–1034.
  33. Dhatt, S.; Sabhaney, V.; Bray, H.; Skarsgard, E.D. Improving the diagnostic accuracy of appendicitis using a multidisciplinary pathway. J. Pediatr. Surg. 2020, 55, 889–892.
  34. Pogorelic, Z.; Buljubasic, M.; Susnjar, T.; Jukic, M.; Pericic, T.P.; Juric, I. Comparison of open and laparoscopic appendectomy in children: A 5-year single center experience. Indian Pediatr. 2019, 56, 299–303.
  35. Jukić, M.; Antišić, J.; Pogorelić, Z. Incidence and causes of 30-day readmission rate from discharge as an indicator of quality care in pediatric surgery. Acta Chir. Belg. 2021.
  36. Mihanović, J.; Šikić, N.L.; Mrklić, I.; Katušić, Z.; Karlo, R.; Jukić, M.; Jerončić, A.; Pogorelić, Z. Comparison of new versus reused Harmonic scalpel performance in laparoscopic appendectomy in patients with acute appendicitis-a randomized clinical trial. Langenbeck’s Arch. Surg. 2021, 406, 153–162.
  37. Perko, Z.; Bilan, K.; Pogorelić, Z.; Druzijanić, N.; Srsen, D.; Kraljević, D.; Juricić, J.; Krnić, D. Acute appendicitis and ileal perforation with a toothpick treated by laparoscopy. Coll. Antropol. 2008, 32, 307–309.
  38. Podda, M.; Gerardi, C.; Cillara, N.; Fearnhead, N.; Gomes, C.A.; Birindelli, A.; Mulliri, A.; Davies, R.J.; Di Saverio, S. Antibiotic treatment and appendectomy for uncomplicated acute appendicitis in adults and children: A systematic review and meta-analysis. Ann. Surg. 2019, 270, 1028–1040.
  39. Umakanthan, S.; Sahu, P.; Ranade, A.V.; Bukelo, M.M.; Rao, J.S.; Abrahao-Machado, L.F.; Dahal, S.; Kumar, H.; Kv, D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad. Med. J. 2020, 96, 753–758.
  40. Westgard, B.C.; Morgan, M.W.; Vazquez-Benitez, G.; Erickson, L.O.; Zwank, M.D. An analysis of changes in emergency department visits after a state declaration during the time of COVID-19. Ann. Emerg. Med. 2020, 76, 595–601.
  41. Boserup, B.; McKenney, M.; Elkbuli, A. The impact of the COVID-19 pandemic on emergency department visits and patient safety in the United States. Am. J. Emerg. Med. 2020, 38, 1732–1736.
  42. Fonseca, M.K.; Trindade, E.N.; Costa Filho, O.P.; Nácul, M.P.; Seabra, A.P. Impact of COVID-19 outbreak on the emergency presentation of acute appendicitis. Am. Surg. 2020, 86, 1508–1512.
  43. Place, R.; Lee, J.; Howell, J. Rate of pediatric appendiceal perforation at a children’s hospital during the COVID-19 pandemic compared with the previous year. JAMA Netw. Open 2020, 3, e2027948.
  44. Gerall, C.D.; DeFazio, J.R.; Kahan, A.M.; Fan, W.; Fallon, E.M.; Middlesworth, W.; Stylianos, S.; Zitsman, J.L.; Kadenhe-Chiweshe, A.V.; Spigland, N.A.; et al. Delayed presentation and sub-optimal outcomes of pediatric patients with acute appendicitis during the COVID-19 pandemic. J. Pediatr. Surg. 2021, 56, 905–910.
  45. Orthopoulos, G.; Santone, E.; Izzo, F.; Tirabassi, M.; Pérez-Caraballo, A.M.; Corriveau, N.; Jabbour, N. Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am. J. Surg. 2021, 221, 1056–1060.
  46. Sheath, C.; Abdelrahman, M.; MacCormick, A.; Chan, D. Paediatric appendicitis during the COVID-19 pandemic. J. Paediatr. Child. Health 2021, 57, 986–989.
  47. Theodorou, C.M.; Beres, A.L.; Nguyen, M.; Castle, S.L.; Faltermeier, C.; Shekherdimian, S.; Tung, C.; DeUgarte, D.A.; Brown, E.G. Statewide impact of the COVID pandemic on pediatric appendicitis in California: A multicenter study. J. Surg. Res. 2021, 267, 132–142.
  48. Bonilla, L.; Gálvez, C.; Medrano, L.; Benito, J. Impact of COVID-19 on the presentation and evolution of acute appendicitis in pediatrics. An. Pediatr. 2021, 94, 245–251.
  49. Delgado-Miguel, C.; Muñoz-Serrano, A.J.; Miguel-Ferrero, M.; De Ceano-Vivas, M.; Calvo, C.; Martínez, L. Complicated acute appendicitis during COVID-19 pandemic: The hidden epidemic in children. Eur. J. Pediatr. Surg. 2021.
  50. Meyer, T. Impact of the COVID-19 pandemic on appendicitis in COVID-19 negative children. Mon. Childcare 2021.
  51. Schäfer, F.M.; Meyer, J.; Kellnar, S.; Warmbrunn, J.; Schuster, T.; Simon, S.; Meyer, T.; Platzer, J.; Hubertus, J.; Seitz, S.T.; et al. Increased incidence of perforated appendicitis in children during COVID-19 pandemic in a bavarian multi-center study. Front. Pediatr. 2021, 9, 683607.
  52. Esparaz, J.R.; Chen, M.K.; Beierle, E.A.; Anderson, S.A.; Martin, C.A.; Mortellaro, V.E.; Rogers, D.A.; Mathis, M.S.; Russell, R.T. Perforated appendicitis during a pandemic: The downstream effect of COVID-19 in children. J. Surg. Res. 2021, 268, 263–266.
  53. Percul, C.; Cruz, M.; Curiel Meza, A.; González, G.; Lerendegui, L.; Malzone, M.C.; Liberto, D.; Lobos, P.; Imach, B.E.; Moldes, J.M.; et al. Impact of the COVID-19 pandemic on the pediatric population with acute appendicitis: Experience at a general, tertiary care hospital. Arch. Argent. Pediatr. 2021, 119, 224–229.
  54. Kostopoulou, E.; Gkentzi, D.; Papasotiriou, M.; Fouzas, S.; Tagalaki, A.; Varvarigou, A.; Dimitriou, G. The impact of COVID-19 on paediatric emergency department visits. A one-year retrospective study. Pediatr. Res. 2021.
  55. Holzman, S.A.; Ahn, J.J.; Baker, Z.; Chuang, K.W.; Copp, H.L.; Davidson, J.; Davis-Dao, C.A.; Ewing, E.; Ko, J.; Lee, V.; et al. A multicenter study of acute testicular torsion in the time of COVID-19. J. Pediatr. Urol. 2021, 17, 478.e1–478.e6.
  56. Schirmer, C.M.; Ringer, A.J.; Arthur, A.S.; Binning, M.J.; Fox, W.C.; James, R.F.; Levitt, M.R.; Tawk, R.G.; Veznedaroglu, E.; Walker, M.; et al. Delayed presentation of acute ischemic strokes during the COVID-19 crisis. J. Neurointerv. Surg. 2020, 12, 639–642.
  57. Balzora, S.; Issaka, R.B.; Anyane-Yeboa, A.; Gray, D.M., 2nd; May, F.P. Impact of COVID-19 on colorectal cancer disparities and the way forward. Gastrointest. Endosc. 2020, 92, 946–950.
  58. Collard, M.; Lakkis, Z.; Loriau, J.; Mege, D.; Sabbagh, C.; Lefevre, J.H.; Maggiori, L. Antibiotics alone as an alternative to appendectomy for uncomplicated acute appendicitis in adults: Changes in treatment modalities related to the COVID-19 health crisis. J. Visc. Surg. 2020, 157, S33–S42.
  59. Köhler, F.; Müller, S.; Hendricks, A.; Kastner, C.; Reese, L.; Boerner, K.; Flemming, S.; Lock, J.F.; Germer, C.T.; Wiegering, A. Changes in appendicitis treatment during the COVID-19 pandemic—A systematic review and meta-analysis. Int. J. Surg. 2021, 95, 106148.
  60. Scott, C.; Lambert, A. Managing appendicitis during the COVID-19 pandemic in the UK. Br. J. Surg. 2020, 107, e271.
  61. Veziant, J.; Bourdel, N.; Slim, K. Risks of viral contamination in healthcare professionals during laparoscopy in the Covid-19 pandemic. J. Visc. Surg. 2020, 157, S59–S62.
  62. Parreira, J.G.; DE-Godoy, L.G.L.; DE-Campos, T.; Lucarelli-Antunes, P.S.; DE-Oliveira-E-Silva, L.G.; Santos, H.G.; Luna, R.A.; Portari Filho, P.E.; Assef, J.C. Management of acute appendicitis during the COVID-19 pandemic: Views of two Brazilian surgical societies. Rev. Colégio Bras. Cir. 2021, 48, e20202717.
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Subjects: Surgery
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Entry Collection: COVID-19
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Update Date: 07 Jan 2022
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