Acute Appendicitis in COVID-19-Positive Children: Report of 4 Cases from an Endemic Area in Northeastern Romania

Filip, Florin; Baitan, Monica Terteliu; Avramia, Ramona; Filip, Roxana

doi:10.3390/ijerph20010706

Cited by 5 publications

(6 citation statements)

References 24 publications

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“…Four (4) patients from this group were diagnosed with acute appendicitis and they were included in a previous article. [ 30 ] The main data related to the remaining 14 patients are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The methodology of the study was similar to the one reported in previous studies. [29][30][31] Informed consent for treatment and data sharing/ publication had been obtained in all cases from the legal guardians at admission, in order to make use of these data for research purposes. Consent from the Ethical Committee of the hospital was obtained and the patients were deidentified.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

Filip,

Avramia,

Terteliu-Baitan

et al. 2023

Medicine

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Rationale: The COVID-19 pandemic had a dramatic effect on various health systems in terms of admissions and outcomes, including pediatric surgery activity. The aim of this paper was to analyze the outcome of SARS-CoV-2-positive patients admitted to our department during the regional COVID-19 pandemic in North-Eastern Romania. We also evaluated the changes generated in our daily practice by the COVID-19 pandemic and the dynamic response to this major challenge. Patient concerns: The patients presented with symptoms related to their primary diagnosis: local pain and deformity in case of fractures; pain, swelling, and erythema in case of abscess; pain and decreased range of motion (ROM) in case of intolerance to metal implants. Other specific concerns are mentioned on an individual basis. Diagnoses: Eighteen patients (of which 4 had acute appendicitis and were included in a previous article), representing 1.18% of the total number of admissions, tested positive for SARS-CoV-2. There were 4 patients with fractures, 3 patients with soft tissue abscess or cellulitis, 2 patients with intolerance to metal implants, 1 patient with facial burn, 1 patient with thumb laceration, 1 patient with liver trauma, 1 patient with undescende testis, and 1 patient with symptomatic inguinal hernia, respectively. Boys represented 11/ 14 (78.57%) of the cases. The mean age of the patients was 9 years 11 months. There were only mild COVID-19 cases. Interventions: Surgery was performed in 13/ 14 (95.71%) of cases. The fractures were treated with open reduction internal fixation (ORIF); incision and drainage (I & D) were performed in case of soft tissue abscess; the metal implants were removed in case of local intolerance. Other conditions (burn, inguinal hernia, undescended testis, skin laceration) were treated specifically. Only 1 patient with liver laceration was treated conservatively under close hemodynamic monitoring. Outcomes: The mean length of stay (LoS) was 2.71 days. The infection with the SARS-CoV-2 virus had no deleterious effect on the surgical outcome among the 14 patients included in the study. There were no surgical complications during admission and no patient returned for late complications related to their primary disease or SARS-CoV-2 infection. Lessons: The SARS-CoV-2 infection had no significant influence on the outcome of pediatric surgical cases included in the study. We noticed a significant (31.54%) decrease in the number of admissions compared to the previous 2-year interval before the COVID-19 pandemic. Fast and adequate adjustment of the daily activity imposed by the COVID-19 pandemic was feasible and may be used in the future should similar epidemiological emergencies occur.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

Filip,

Avramia,

Terteliu-Baitan

et al. 2023

Medicine

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“…In Romania, one of the first authors to observe that the differences between patients with severe and non-severe cases were not statistically significant was Totan et al [56]. Other studies had similar findings [28,32,60].…”

Section: Transaminase Levels and Other Hepatic Markersmentioning

confidence: 94%

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Musat,

Sorop,

Sorop

et al. 2023

Life

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COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.

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“…A recently observed new variant, mimicking AA, 11 – 13 prompts abdominal imaging and surgical evaluation. Pediatric surgeons must first be aware of the GI symptoms of MIS-C to diagnose it correctly.…”

Section: Introductionmentioning

confidence: 99%

“…8 Children with COVID-19 have reported receiving non-operative therapy for simple AA with antibiotics. 9,10 A recently observed new variant, mimicking AA, [11][12][13] prompts abdominal imaging and surgical evaluation. Pediatric surgeons must first be aware of the GI symptoms of MIS-C to diagnose it correctly.…”

Section: Introductionmentioning

confidence: 99%

Coincidental or mimicking acute appendicitis secondary to MIS-C associated with SARS-CoV-2: A case report

Ramosaj-Morina

Keka-Sylaj

Baloku

et al. 2023

SAGE Open Medical Case Reports

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The predominant organic system involved in multisystem inflammatory syndrome in children associated with COVID-19 is the gastrointestinal system, which is observed in almost 90% of patients. Gastrointestinal symptoms can mimic acute appendicitis. There have been a few cases of misdiagnosed multisystem inflammatory syndrome in children associated with SARS-CoV-2 as appendicitis, and a few concomitant cases of a multisystem inflammatory syndrome associated with acute appendicitis during the COVID-19 pandemic. Here, we present the case of an 11-year-old girl who presented to our Intensive Care Unit with a 2-day history of fever, generalized abdominal pain, and vomiting. The clinical findings resulted in a clinical suspicion of acute appendicitis and subsequent surgery. While postoperatively, she became critically ill, and she was diagnosed with the multisystem inflammatory syndrome in children associated with COVID-19. When diagnosing children with acute appendicitis, healthcare professionals, especially pediatricians and surgeons, must pay attention to the multisystem inflammatory syndrome linked to the SARS-CoV-2 infection.

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Acute Appendicitis in COVID-19-Positive Children: Report of 4 Cases from an Endemic Area in Northeastern Romania

Cited by 5 publications

References 24 publications

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

COVID-19 positive cases in a pediatric surgery department from Romania: Case series from 2 years of pandemics

COVID-19 and Laboratory Markers from Romanian Patients—A Narrative Review

Coincidental or mimicking acute appendicitis secondary to MIS-C associated with SARS-CoV-2: A case report

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