The role of a pediatric tertiary care center in avoiding collateral damage for children with acute appendicitis during t
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ORIGINAL ARTICLE
The role of a pediatric tertiary care center in avoiding collateral damage for children with acute appendicitis during the COVID‑19 outbreak Louise Montalva1 · Aurore Haffreingue1 · Liza Ali1 · Simon Clariot2 · Florence Julien‑Marsollier3 · Alaa El Ghoneimi1,4 · Matthieu Peycelon1,4 · Arnaud Bonnard1,4 Accepted: 6 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To evaluate the impact of the COVID-19 pandemic-related lockdown on management and outcomes of children with acute appendicitis. Methods A retrospective cohort study was conducted, including children treated for acute appendicitis (January 20th–May 11th, 2020). The data regarding the severity of appendicitis and outcome were collected and compared for two time periods, before and after the nationwide lockdown (March 17th, 2020). Results The number of cases of acute appendicitis increased by 77% during the lockdown (n = 39 vs. n = 69, p = 0.03). During the lockdown, children treated for appendicitis were older (11.1 vs. 8.9 years, p = 0.003), and were more likely to live more than 5 km away from our institution (77% vs. 52%, p = 0.017). Less children had previously consulted a general practitioner (15% vs. 33%, p = 0.028), whereas more children were transferred from other hospitals (52% vs. 31%, p = 0.043). There was no difference in terms of length of hospital stay, rate of postoperative intra-abdominal abscess, ER visits, and readmissions between both periods. Three children (4%) were diagnosed with COVID-19 and appendicitis. Conclusions Despite an increase in the number of children with appendicitis managed at our hospital during the COVID19-related lockdown, management, and outcome remained similar. Although our pediatric center was strongly affected by this pandemic, maintaining our prior practice strategies for acute appendicitis avoided the occurrence of collateral damage for those children. Keywords SARS-cov-2 · Peritonitis · Pediatric surgery · Laparoscopy · Appendectomy
Introduction
* Arnaud Bonnard [email protected] 1
Department of General Pediatric Surgery and Urology, Robert‑Debré University Hospital, Assistance PubliqueHôpitaux de Paris (AP-HP), 48 boulevard Sérurier, 75019 Paris, France
2
Department of Anesthesia and Intensive Care, Henri‑Mondor University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), Créteil, France
3
Department of Anesthesia and Intensive Care, Robert‑Debré University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
4
University of Paris, Paris, France
After the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in December 2019 in China, COVID-19 rapidly evolved towards a pandemic, requiring complete restructuring of healthcare systems worldwide [1]. With more than 6000 cases of COVID-19 diagnosed between March 1st and March 15th, France was one of the first European countries to be strongly affected by the pandemic [2]. The French government announced a series of widesprea
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