Childhood Appendicitis Ruptures Increasing Due To COVID-19 Delays: Study

New research suggests many parents are delaying medical treatments for children, due to the fear of exposure to COVID-19 at hospitals and healthcare facilities, which may be the cause of an influx in childhood appendicitis ruptures.

In findings published last week in The Journal of the American Medical Association (JAMA), researchers indicate there appears to be a link between the coronavirus and a 21% increase in emergency room visits this year for a ruptured appendix among children.

Appendicitis is a painful inflammation of the appendix, which typically occurs in the teens or 20s. It is the most common cause of acute abdominal pain requiring surgery. Typically, mild to moderate cases are treated with antibiotics alone, but in severe cases an appendectomy to remove the appendix is required to prevent rupture.

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When an appendix ruptures, it allows the contents of the intestines to leak into the abdomen cavity causing a pocket of infection known as an abscess. Typically, the abscess is drained while a course of antibiotics is prescribed so the appendix can be removed at a later time, however if left untreated, sepsis could develop, creating a life threatening condition.

In this recent study, researchers reviewed electronic medical records and identified 90 children who were treated for appendicitis at Inova Children’s Hospital in northern Virginia between March 16 and June 7. Of those treated, nearly 40% had a ruptured appendix. When compared to 2019, 70 children were treated during the same timeframe with only 19% experiencing a ruptured appendix.

The lead researcher involved in the study, Dr. Rick Place, medical director of the pediatric emergency department at Inova, suggests that parents may have delayed having their child seen by a doctor due to the ongoing coronavirus outbreak, resulting in a higher rate of emergency room visits involving appendix ruptures.

Dr. Place indicates the trend is parallel with many other routine treatments being delayed during the early months of the pandemic, as the study found a 38% decline in patients receiving post-heart attack treatments and fewer patients with ischemic stroke.

Overall, the study indicates patient volume seen in the emergency department decreased from a mean of 144 patients per day to 65 patients per day, reflecting a 55% decrease.

While unnecessary treatment at hospitals and healthcare facilities during the outbreak is encouraged by some medical professionals, Place indicates a broad avoidance and delay in medical treatment may lead to an overall increased morbidity and mortality rate in both children and adults.

Recent studies suggest delays in treatment or screenings for certain condition such as cancer can have severe medical health consequences.

In November, a study was published in the medical journal The BMJ, indicating even a one month delay or failure to detect cancer could be the difference between life and death for some patients.

The findings appear to indicate a significant association between delayed diagnosis and cancer patients’ risk of death in 13 of 16 indications, finding a delay in surgery increased the risk of death slightly across patients diagnosed with cancers of the bladder, breast, colon, rectum, lung, cervix, and head and neck.


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