Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period?
Introduction: The Coronavirus Disease-2019 (COVID-19) had profound repercussions on routine medical practices all over the globe. There are fewer studies on the impact of the pandemic on childhood surgical conditions like Acute Appendicitis (AA), which is the most common paediatric surgical emergenc...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-05-01
|
| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/17829/62072_CE[Ra1]_F(IS)_PF1(JY_KM)_PFA(JY_KM)_PN(KM).pdf |
| _version_ | 1797818545978998784 |
|---|---|
| author | Shinaz Sadiq MK Binu UR Maneesha SV Beena CS Aravind |
| author_facet | Shinaz Sadiq MK Binu UR Maneesha SV Beena CS Aravind |
| author_sort | Shinaz Sadiq |
| collection | DOAJ |
| description | Introduction: The Coronavirus Disease-2019 (COVID-19) had profound repercussions on routine medical practices all over the globe. There are fewer studies on the impact of the pandemic on childhood surgical conditions like Acute Appendicitis (AA), which is the most common paediatric surgical emergency.
Aim: To analyse whether COVID-19 has influenced the clinical profile and management of paediatric appendicitis during the pandemic period.
Materials and Methods: A retrospective study was carried out in the Department of Paediatric Surgery, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India, comparing AA cases during the pandemic period (group A=from February 2020 to January 2022) with AA cases during the prepandemic period (group B=from February 2018 to January 2020). Analysis of data regarding patient demographics (age, sex), duration of symptoms and hospital stay, type of appendicitis, total and differential leucocyte count, ultrasonographic findings, treatment modality and complications was done. Subgroup analysis of children in group A was done by comparing AA cases with active/recent COVID-19 infection (Subgroup A1) with the rest of AA in the group (Subgroup A2). Pearson’s Chi-square test was used for the analysis of categorical variables and independent t-test was used for numerical data. p-value<0.05 was considered significant.
Results: There were 826 AA cases, with 375 children in group A and 451 in group B. A significant reduction in the number of AA cases was noted during the first year of the pandemic (n=167 vs n=242, p-value=0.009) and a significantly higher number of cases were managed conservatively during the pandemic period (n=48 vs n=10, p-value <0.0001). Children with active/recent COVID-19 infection presented late (p-value=0.03), had a significantly higher incidence of complicated appendicitis (p-value=0.02), decreased total leucocyte count (p-value=0.01), decreased polymorph count (p-value=0.02) and higher incidence of the conservative modality of treatment (p-value<0.005).
Conclusion: Overall, there were no significant differences in the clinical profile of AA during the pandemic period. But, children with AA who had active/recent COVID-19 infection had a longer duration of symptoms and a higher incidence of complicated appendicitis. The pandemic influenced the management protocols with an increase in the number of AA cases being managed conservatively when compared to the prepandemic period. |
| first_indexed | 2024-03-13T09:09:28Z |
| format | Article |
| id | doaj.art-089f2161aed34e909dff712655edad7b |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-13T09:09:28Z |
| publishDate | 2023-05-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-089f2161aed34e909dff712655edad7b2023-05-27T10:57:56ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-05-01175PC28PC3310.7860/JCDR/2023/62072.17829Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period?Shinaz Sadiq0MK Binu1UR Maneesha2SV Beena3CS Aravind4Associate Professor, Department of Pediatric Surgery, Government TD Medical College, Alappuzha, Kerala, India.Assistant Professor, Department of Pediatric Surgery, Government Medical College, Thiruvananthapuram, Kerala, India.Associate Professor, Department of Pediatric Surgery, Government Medical College, Calicut, Kerala, India.Professor, Department of Pediatric Surgery, Government Medical College, Thiruvananthapuram, Kerala, India.Associate Professor, Department of Pediatric Surgery, Government Medical College, Thiruvananthapuram, Kerala, India.Introduction: The Coronavirus Disease-2019 (COVID-19) had profound repercussions on routine medical practices all over the globe. There are fewer studies on the impact of the pandemic on childhood surgical conditions like Acute Appendicitis (AA), which is the most common paediatric surgical emergency. Aim: To analyse whether COVID-19 has influenced the clinical profile and management of paediatric appendicitis during the pandemic period. Materials and Methods: A retrospective study was carried out in the Department of Paediatric Surgery, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India, comparing AA cases during the pandemic period (group A=from February 2020 to January 2022) with AA cases during the prepandemic period (group B=from February 2018 to January 2020). Analysis of data regarding patient demographics (age, sex), duration of symptoms and hospital stay, type of appendicitis, total and differential leucocyte count, ultrasonographic findings, treatment modality and complications was done. Subgroup analysis of children in group A was done by comparing AA cases with active/recent COVID-19 infection (Subgroup A1) with the rest of AA in the group (Subgroup A2). Pearson’s Chi-square test was used for the analysis of categorical variables and independent t-test was used for numerical data. p-value<0.05 was considered significant. Results: There were 826 AA cases, with 375 children in group A and 451 in group B. A significant reduction in the number of AA cases was noted during the first year of the pandemic (n=167 vs n=242, p-value=0.009) and a significantly higher number of cases were managed conservatively during the pandemic period (n=48 vs n=10, p-value <0.0001). Children with active/recent COVID-19 infection presented late (p-value=0.03), had a significantly higher incidence of complicated appendicitis (p-value=0.02), decreased total leucocyte count (p-value=0.01), decreased polymorph count (p-value=0.02) and higher incidence of the conservative modality of treatment (p-value<0.005). Conclusion: Overall, there were no significant differences in the clinical profile of AA during the pandemic period. But, children with AA who had active/recent COVID-19 infection had a longer duration of symptoms and a higher incidence of complicated appendicitis. The pandemic influenced the management protocols with an increase in the number of AA cases being managed conservatively when compared to the prepandemic period.https://www.jcdr.net/articles/PDF/17829/62072_CE[Ra1]_F(IS)_PF1(JY_KM)_PFA(JY_KM)_PN(KM).pdfappendectomyinflammationpolymerase chain reactionsevere acute respiratory syndrome coronavirus 2 |
| spellingShingle | Shinaz Sadiq MK Binu UR Maneesha SV Beena CS Aravind Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? Journal of Clinical and Diagnostic Research appendectomy inflammation polymerase chain reaction severe acute respiratory syndrome coronavirus 2 |
| title | Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? |
| title_full | Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? |
| title_fullStr | Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? |
| title_full_unstemmed | Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? |
| title_short | Paediatric Appendicitis: Has SARS-COV-2 Influenced the Clinical Profile and Management during the Pandemic Period? |
| title_sort | paediatric appendicitis has sars cov 2 influenced the clinical profile and management during the pandemic period |
| topic | appendectomy inflammation polymerase chain reaction severe acute respiratory syndrome coronavirus 2 |
| url | https://www.jcdr.net/articles/PDF/17829/62072_CE[Ra1]_F(IS)_PF1(JY_KM)_PFA(JY_KM)_PN(KM).pdf |
| work_keys_str_mv | AT shinazsadiq paediatricappendicitishassarscov2influencedtheclinicalprofileandmanagementduringthepandemicperiod AT mkbinu paediatricappendicitishassarscov2influencedtheclinicalprofileandmanagementduringthepandemicperiod AT urmaneesha paediatricappendicitishassarscov2influencedtheclinicalprofileandmanagementduringthepandemicperiod AT svbeena paediatricappendicitishassarscov2influencedtheclinicalprofileandmanagementduringthepandemicperiod AT csaravind paediatricappendicitishassarscov2influencedtheclinicalprofileandmanagementduringthepandemicperiod |