1. Acute Abdomen and Appendicitis in 1010 Pediatric Patients With COVID-19 or MIS-C: A Multinational Experience from Latin America
- Author
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Roger Hernández Díaz, Jorge Alberto Rios Aida, Jessica Gomez-Vargas, Rolando Ulloa-Gutierrez, Martin Brizuela, Francisco Campos, Adriana Yock-Corrales, Danilo Buonsenso, Erick Arteaga-Menchaca, Jacopo Lenzi, Omar Yassef Antúnez-Montes, Lina Maria Betancur Londoño, Verónica Kozicki, Fadia Uribe, Olguita del Aguila, Andrea Parra Buitrago, Yock-Corrales A., Lenzi J., Ulloa-Gutierrez R., Gomez-Vargas J., Antunez-Montes O.Y., Rios Aida J.A., Del Aguila O., Arteaga-Menchaca E., Campos F., Uribe F., Diaz R.H., Buitrago A.P., Londono L.M.B., Kozicki V., Brizuela M., and Buonsenso D.
- Subjects
Male ,Microbiology (medical) ,appendicitis ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,appendiciti ,Original Studies ,children ,medicine ,Humans ,Leukocytosis ,Child ,Abdomen, Acute ,SARS-CoV-2 ,business.industry ,Infant, Newborn ,COVID-19 ,Infant ,medicine.disease ,Systemic Inflammatory Response Syndrome ,Appendicitis ,Latin America ,Infectious Diseases ,Acute abdomen ,Child, Preschool ,Radiological weapon ,Clinical diagnosis ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,business ,Human ,Abdominal surgery - Abstract
Background: To date, there are only sporadic reports of acute abdomen and appendicitis in children with coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in children (MIS-C). Methods: Children 17 years of age or younger assessed in 5 Latin American countries with a diagnosis of microbiologically confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and children fulfilling MIS-C definition were included. For children with acute abdomen, we investigate main radiologic patterns, surgical treatment and intraoperative findings, outcomes. Findings: One-thousand ten children were enrolled. Forty-two children (4.2%) had a clinical diagnosis of acute abdomen. Four (9.5%) were diagnosed with MIS-C and did not undergo surgery. The remaining 38 children (3.8%) underwent abdominal surgery due to suspected appendicitis, 34 of them (89.7%) had an intraoperative diagnosis of acute appendicitis (AA), while 4 of them had nonsurgical findings. Eight children died (0.8%), none of them being diagnosed with appendicitis. Children with AA were significantly older than those without (P < 0.0001). Children with complicated appendicitis had more frequently fever (85.7% vs. 60%), intestinal distension on the abdominal radiograph (7.1% vs. none), leukocytosis (85.7% vs. 40%) and high levels of C-reactive protein (35.7% vs. 5%), although differences were not statistically significant. Conclusions: Our study showed that children may present with acute abdomen during COVID-19 or MIS-C, which is not always associated with intraoperative findings of appendicitis, particularly in case of MIS-C. Further studies are needed to better characterize children with acute abdomen during COVID-19 or MIS-C, to avoid delay in diagnosis of surgical conditions and at the same time, minimize unnecessary surgical approaches.
- Published
- 2021