Background and objectives: Since the COVID-19 pandemic confinement was established in Spain on March 9, 2020, the number of visits to the paediatric Emergency Department (ED) has decreased dramatically, probably due to the fear of parents becoming infected in the hospital environment. The aim of this work was to analyse the medium-term consequences during the first 9 months after the onset of the COVID-19 pandemic in children with acute appendicitis (AA). Material and Methods: A retrospective study was performed on children operated on for AA in our institution between 2017-2020, who were distributed in two groups according to the date of surgery: COVID-19 group (after March 9, 2020) and control group (before March 9, 2020). Demographic variables, associated symptoms, time from symptoms onset, hospital stay, rate of complicated AA and postoperative complications were analysed. Results: A total of 1274 patients were included (288 COVID group; 986 control group), without demographic differences. Time from symptom onset was significantly longer in COVID-19 group (34.5 vs. 24.2 hours; p=0.021), although no differences in associated symptoms were observed between both groups. COVID-19 group presented a higher rate of complicated AA (20.1% vs. 14%; OR: 1.55; CI95%[1.10-2.18]; p=0.008), a longer hospital stay (3.5 vs. 2.8 days; p=0.042) as well as a higher rate of postoperative complications (21.5% vs. 15.7%; OR: 1.47; CI95%[(1.06-2.04)]; p=0.008). Conclusion: In our experience there was a negative medium-term effects of the COVID-19 pandemic on children with acute appendicitis: delayed ED visits, increased rate of complicated AA, increased hospital stay and increased postoperative complications.

Introduction: Since the COVID-19 pandemic confinement was established in Spain on March 9, 2020, the number of visits to the paediatric Emergency Department (ED) has decreased dramatically, probably due to the fear of parents becoming infected in the hospital environment. The aim of this work is to analyse the medium-term consequences during the first 9 months after the onset of the COVID-19 pandemic in children with acute appendicitis (AA).Methods: A retrospective study was performed on children operated on for AA in our institution between 2017-2020, who were distributed in two groups according to the date of surgery: COVID-19 group (after March 9, 2020) and control group (before March 9, 2020). Demographic variables, associated symptoms, time from symptoms onset, hospital stay, rate of complicated AA and postoperative complications were analysed.Results: A total of 1274 patients were included (288 COVID group; 986 control group), without demographic differences between them. Time from symptom onset was significantly longer in COVID-19 group patients (34.5 vs. 24.2 hours; p=0.021), although no differences in associated symptoms were observed between both groups. COVID-19 group patients presented a higher rate of complicated AA (20.1% vs. 14%; OR: 1.55; CI95%[1.10-2.18]; p=0.008), a longer hospital stay (3.5 vs. 2.8 days; p=0.042) as well as a higher rate of postoperative complications (21.5% vs. 15.7%; OR: 1.47; CI95%[(1.06-2.04)]; p=0.008).Conclusion: This study shows the negative medium-term effects of the COVID-19 pandemic on children with acute appendicitis: delayed ED visits, increased rate of complicated AA, increased hospital stay and increased postoperative complications.