Frequency and Complications of Acute Appendicitis before and during the COVID-19 Pandemic: A Retrospective Study in a Children's Hospital in North of Iran

Appendicitis is one of the reasons for abdominal pain and the most common cause of referral to pediatric emergency departments. There are different results on the frequency and complications of appendicitis during COVID-19 pandemic. This study aims to compare the frequency and complications of acute appendicitis in children who underwent laparotomy before and during the COVID-19 pandemic in Babol Children's Hospital, north of Iran.

This retrospective study was conducted in 172 children with acute appendicitis who underwent laparotomy. Children were divided into two groups according to the time of referral; before the COVID-19 pandemic (between December 2018 and November 2019) and during the pandemic (between March 2019 and February 2020).  Surgeon’s observations in laparotomy and also the complications (perforation, abscess, gangrene, and peritonitis) were recorded. Data analysis was carried out using Chi-score and paired t-test.

The children studied included 94 before the COVID-19 pandemic and 78 during the pandemic. The average age was 7.76±2.89 years. Findings showed that 165 (95.9%) and 7 (4.1%) children had confirmed and unconfirmed appendicitis, respectively, indicating no significant difference between the two groups (P=0.45). The complications of appendicitis (perforation, gangrene, abscess, and peritonitis) were 8.25% before the pandemic and 34.2% during the pandemic (P=0.24). There was no significant difference between the two groups in average time interval between the onset of pain and attending the hospital (P=0.38).

In this study, the COVID-19 pandemic did not affect the frequency of acute appendicitis in children. These results probably indicate the proper performance of the treatment staff and the parents' rapid response to their child’s acute abdominal symptoms during the pandemic.