Copyright ©The Author(s) 2022.
World J Methodol. Jan 20, 2022; 12(1): 20-31
Published online Jan 20, 2022. doi: 10.5662/wjm.v12.i1.20
Table 1 Morbidity and mortality in pediatric surgical patients in the pandemic era
Patient number
SARS-CoV-2 test
Study details
Place R et al[14]JAMA Network Open 2020; 3: e202794890N/ACAA: 35CAA + abscess: 8OT: 35; Abscess drainage with IA: 8SuccessfulRetrospective study. The authors noted increased number of CAA compared with the same period in 2019
Kvasnovsky CL et al[15]J Pediatr Surg 2020(Epub head of print)55Positive: 3 (without symptoms)NOT: 25 (2 with CAA); OT: 30 (CAA: 13, Simple AA:17)NOT: 25 pts (3 CAA); OT: 30 (13 CAA); 1 patient SARS-CoV-2+: OT; 2 patients SARS-CoV-2+: NOTSuccessfulRetrospective study. 45.5% of all patients: NOT protocol to minimize operative resources; The majority of children (78.2%) did not meet previous criteria for non-admissions comparable to pre- SARS-CoV-2 era
Gerall CD et al[16]J Pediatr Surg 2020 (Epub head of print)89 (41: pre SARS-CoV-2 era, 48: SARS-CoV-2)Positive: 4 (excluded from the study)UAA and CAANOT: Antibiotics 3 in the pre- SARS-CoV-2 era vs 7 during pandemic; OT: 33 in the pre- SARS-CoV-2 era vs 23 during pandemicSuccessfulRetrospective study. It compares children’s’ symptoms and complications in pro- vs SARS-CoV-2 era. Patients in SARS-CoV-2 era: -Duration of symptoms: longer; -Increased number of imaging findings for perforation, increased LOS, increased time until resolution of symptoms.
Snapiri O et al[17]Acta Pediatr 2020; 109: 1672-16767N/ACAA (perforated, abscess)OT: 4; NOT: 4 (abscess drainage)SuccessfulRetrospective study. Delayed diagnosis: Insufficient initial evaluation, telemedicine: 3, parental concerns)
Fisher JC et al[18]Ann Surg 2020 (Epub head of print)57 patients SARS-CoV-2 era vs control: 1292Positive: 11/28CAA in the SARS-CoV-2 era: 45% vs 27% in the control groupOT: UAA: 30; CAA: 20; NOT: 7SuccessfulRetrospective study. Comparison of clinical characteristics of children vs pre- SARS-CoV-2 era. Main findings: Higher duration of symptoms and perforation rates in the SARS-CoV-2 era. No differences between perforation rates and LOS among positive or negative SARS-CoV-2 children.
La Pergola F et al[19]Front Pediatr 2020; 8: 60032086 vs 309 in the pre- SARS-CoV-2 eraPositive: 3UAA: 59; CAA: 27N/ASuccessfulRetrospective study. COVID-19 era vs previously (2017-2019); -No differences: in the prevalence of the AA, duration of symptoms and CAA
Raffaele A et al[20]Br J Surg 2020; 107: e529-e53014 Positive: NoneUCC: 7; CAA: 7lOT: 13/14; NOT: 1 (abscess drainage)SuccessfulRetrospective study. -Delayed presentation in the ED vs previous years, delayed admission to OT due to COVID-19 test preoperatively
Montalva L et al[21]Pediatr Surg Int 2020; 36: 1397-1406108 (69 during lockdown)Positive: 3UAA: 24; CAA: 84OT: UAA and CAA with peritonitis:94; CAA with abscess: 14 (drainage or medical treated)SuccessfulRetrospective cohort study. The authors found increased cases of AA during the period of lockdown compared to pre-lockdown era. LOS, complication rates, re-admissions and peritoneal abscesses similar
Bellini T et al[22]Acta Pediatr 2021 (Epub head of print) 27 in the SARS-CoV-2-era vs 75 control groupPositive: NoneUAA: 14; CAA: 13 vs UAA: 50; CAA: 25N/ASuccessfulRetrospective study. CAA cases significantly more when compared with previous 3 yr due to delayed admissions (P = 0.004)
Zampieri N et al[23]Minerva Pediatr 2020;N/AN/AN/AN/AN/ARetrospective study. The authors found decreased number cases of AA during lockdown vs post-lockdown period (P < 0.05) possibly due to the less exposure to co-factors
Velayos M et al[24]Ann Pediatr (Barc) 2020; 93: 118-122Pre- SARS-CoV-2-era: 41; Post- SARS-CoV-2: 25Positive: 1CAA: -pre- SARS-CoV-2: 3; -post- SARS-CoV-2: 8OT: All patientsSuccessfulRetrospective study. Increased number of CAA in SARS-CoV-2 era compared to pre- SARS-CoV-2 era due to delayed diagnosis (P = 0.019), LOS increased in the CAA SARS-CoV-2 group
Malhotra A et al[25]Pediatr Inf Dis J 2021; 40: e49-e5510 Positive: 10CAA+MIS-C-: 5; UAA: 5OT: 8; NOT: 2SuccessfulRetrospective study. CAA associated with MIS-C
Cai et al[26]Front Pediatr 2020;8: 1-95Positive: 51 patient: CAA + MIS-COTSuccessfulRetrospective study. CAA associated with MIS-C
Schäfer FM et al[27]Front Pediatr 2021; 9: 683607514N/ACAA
Zvizdic Z et al[28]J Pediatr Surg 2021; 56: 196-2006Positive: NoneAAOTSuccessfulLetter to the Editor. Decreased admissions of AA compared to pre- SARS-CoV-2 era. Hypothesis: Correlation with decreased exposure to microbes due to lockdown
Lishman J et al[29]J Pediatr Infect Dis 2020; 39: e472-e473 4Positive: 4 UAA: 4; CAA: 2; MIS-C: 3OT: 3SuccessfulCase series. AA with MIS-C
Meyer JS et al[30]J Pediatr Surg Case Rep 2021; 64: 1017344Positive: AllUAA: 2; CAA: 2OT: 4SuccessfulCase series. Possible association of SARS-CoV-2 with AA
Lee-Archer P et al[31]J Pediatr Child Health 2020; 56: 1313-131448N/AUAA: 25; CAA: 23OTSuccessfulBrief communication. Increased number of CAA compared to previous years (2014-2019), parental concerns
Wang H et al[32]Chin J Pediatr Surg 2020; 41: 299-3021PositiveUAA +; pneumoniaOTCase report. UUA associated with pneumonia of the right lung
Harwood R[33]J Surg Case Rep 2020; 9: 1-32Positive: 1CAA + MIS-COTSuccessfulCase report. CAA associated with MIS-C
Shahbaznejad L[34]BMC Pediatrics 2020; 51310Positive: 101 patient: UAA with MIS-COTSuccessfulCase report. UAA associated with MIS-C
Alsuwallem AB et al[35]Cureus 2020; 12: e86771PositiveCAA OTSuccessfulCase report. CAA associated with COVID-19 Infection
Mehl SC et al[36]Pediatr Infect Dis J 20211PositiveNECNOTSuccessfulCase report. Full term neonate with NEC secondary to SARS-CoV-2 infection
Rohani P et al[37]J Pediatr Surg Case Rep 2021; 61: 1016671PositiveNECNOTSuccessfulCase report. Gastrointestinal SARS-CoV-2 manifestation
Moazzam Z et al[38]J Pediatr Surg Case Reports 2020; 59:1015331PositiveIntussusceptionPneumatic reductionSuccessfulCase report. Gastrointestinal manifestation of SARS-CoV-2
Rajalakshmi L et al[39]Indian J Pract Pediatr 2020; 22:2361PositiveIntussusceptionPneumatic reductionSuccessfulCase report. Gastrointestinal manifestation of SARS-CoV-2
Martinez-Castañoi[40]Pediatr Emerg Care 2020;36: e3681PositiveIntussusceptionHydrostatic reductionSuccessfulCase report. Gastrointestinal manifestation of COVID-19
Makrinioti H et al[41]J Pediatric Infect Dis Soc 2020; 9: 504-5062Positive: 2Intussusception; Intussusception + malrotationPneumatic reduction; Surgical reduction + ladd procedureDeath; SuccessfulCase reports. Fatal gastrointestinal manifestation of SARS-CoV-2; Gastrointestinal manifestation of SARS-CoV-2
Bazuaye-Ekhuyasi EA et al[42]Emerg Radiol 2020; 27: 761-7641PositiveIntussusceptionHydrostatic reductionSuccessfulCase report. Gastrointestinal manifestation of SARS-CoV-2
Guerrón N et al[43]Global Pediatr Health 2021; 8: 1-31PositiveIntussusception Hydrostatic reduction SuccessfulCase report. Gastrrointestinal manifestation of COVID-19
Osorno JF et al[44]Global Pediatr Health 2021; 8: 1-31PositiveIntussusception (delayed presentation)LaparotomySuccessfulCase report. Gastrrointestinal manifestation of COVID-19
Kawalec AM[45]Burns 2020; 46: 1713-1714Increased admissions in ED compared to previous yearN/AIncreased TBSA burns, house fire burns and PICU admissions vs previous yearOutpatient care, hospitalization, PICUN/ARetrospective study. Need for a family plan during pandemic
Demicran M[46]Burns 2020 (Epub ahead of print)Increased admissions and hospitalizations compared to previous yearN/AIncreased TBSA burns, increased all kinds of burnsOutpatient care, hospitalizationN/ARetrospective study. Burn care material must be ready
Sethuraman U[47]Burns 2020 (Epub head of print)Increased admissions in ED vs all visitsN/AIncreased TBSA Outpatient care, hospitalization, PICU1 deathRetrospective study. Parents should keep children away from hot liquids and surfaces
Pelizzo G et al[48]Healthcare 2021; 9: 55184 (pandemic era: 52previous pre-pandemic period: 32)Positive: 1 TBSA < 10%: 32; 10%-15%: 11; > 15% >: 934/52: Discharge; 18/52: Burn Service Area; (10/18: Ward; 8/18: PICU)SuccessfulRetrospective study. A higher number of admissions during pandemic was noticed compared to the same period in the previous year. An appropriate planned service and care ensure a safe and feasible hospitalization without risks of infections and major complications
Marino-Mateo L et al[49]Actas UrolEsp 2020; 44: 659-65445 Positive: 0Pelviureteric junction obstruction, spina bifida, lithiasis, hypospadias49 interventionsSuccessfulRetrospective study. A stratification of the urological based on the different phases of pandemic and EAU was conducted
Cesaro S et al[50]Pediatr Blood Cancer 2020; 67: e8466247 Positives: 10Solid tumors, leukemiaCeased chemotherapy and radiation for 12-26 dSuccessfulRetrospective study. Mild or asymptomatic patients with positive tests may continue therapy
Hrusak O et al[51]Eur J Cancer 2020;132: 11-16200Positives: 9Hepatoblastoma: 2; Wilms tumor: 1; Ewing’s sarcoma: 1; osteosarcoma: 1; cervical rhabdoid: 1; ALL: 1 Antibiotics and/or hydroxychoroquine, lopinavir, ritonavirSuccessfulRetrospective study. Children on anticancer therapy may have mild or asymptomatic course of infection with SARS-CoV-2. In this case anticancer treatment should not be delayed or postponed
Madhusiidhan PP et al[52]Pediatr Blood Cancer 2020; e28843578Positive: 98; No symptoms: 73Neuroblastoma: 5,Solid tumor: 16; Others: 77Mechanical; ventilation: 7; Supplemental oxygen: 25; SARS-CoV-2 direct treatment: 98Successful: 94; Death: 4Multi-institutional cohort study. Low morbidity and mortality among oncologic patients but higher than in general pediatrics. Significant impact of pandemic: Delay in therapy in 67% of positive patients; Overall delays: Chemotherapy 54%, surgery 46%, transplant 30%