From the Departments of Pediatrics Emergency.
Pediatric Surgery, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.
Pediatr Emerg Care. 2021 Mar 1;37(3):185-190. doi: 10.1097/PEC.0000000000002364.
The aim of this study was to describe the incidence of complicated appendicitis during the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic lockdown.
This was a retrospective study of pediatric patients diagnosed with acute appendicitis in a single pediatric institution that assumed care responsibility for most of the pediatric emergencies during the lockdown period in Madrid (Spain). A control group was made up of the same number of patients diagnosed the previous year.
One hundred fifty-one patients diagnosed with acute appendicitis were included (77 during self-quarantine and 74 during the previous year). The incidence of complicated appendicitis was 38.9% versus 28.3%, showing no significant differences. The 2 groups were homogeneous, with no differences in time elapsed between symptom onset and first emergency department visit, laboratory test results, median length of stay, intensive care admissions, or patients correctly diagnosed on their first visit.
COVID-19 (coronavirus disease 2019) self-quarantine has not increased the incidence of complicated appendicitis, and children who developed complicated appendicitis did not have worse clinical outcomes. Parents did not delay presenting for medical attention, and emergency department pediatricians did not fail to diagnose this condition. Reorganization of hospital resources, fast-track treatment protocols for noncomplicated appendicitis, and extended use of home-stay hospitalization for complicated appendicitis could have contributed to these favorable outcomes.
本研究旨在描述 SARS-CoV-2（严重急性呼吸综合征冠状病毒 2）大流行封锁期间复杂阑尾炎的发病率。
这是一项回顾性研究，涉及一家儿科机构诊断为急性阑尾炎的儿科患者，该机构在马德里（西班牙）封锁期间承担了大部分儿科急诊的护理责任。对照组由同年诊断的相同数量的患者组成。
共纳入 151 例急性阑尾炎患者（自我隔离期间 77 例，前一年同期 74 例）。复杂阑尾炎的发病率为 38.9%与 28.3%，无显著差异。两组具有同质性，症状出现与首次急诊科就诊之间的时间、实验室检查结果、平均住院时间、重症监护病房入院和首次就诊时正确诊断的患者无差异。
COVID-19（2019 年冠状病毒病）自我隔离并未增加复杂阑尾炎的发病率，且发生复杂阑尾炎的儿童临床结局并未恶化。父母并未延迟就诊，急诊科儿科医生也未未能诊断出这种疾病。医院资源的重新组织、非复杂性阑尾炎的快速治疗方案以及复杂性阑尾炎的家庭住院时间延长可能促成了这些良好的结果。
