ABSTRACT
Over recent years, amid the novel coronavirus disease (COVID-19) pandemic the prevalence of appendicitis in children has increased. However, its morphological characteristics are not described completely. The article elucidates clinical and morphological features of gangrenous appendicitis in hospitalized children with laboratory-confirmed COVID-19 diagnosis. The authors present the clinical, laboratory, instrumental and morphological findings in schoolchildren with gangrenous appendicitis associated with SARS-CoV-2, confirmed by nasopharyngeal swab PCR-testing. The disease was characterized by an acute onset, rapid development of abdominal pain syndrome and typical inflammatory changes in the clinical blood analysis: moderate leukocytosis (15.6×109/l), pronounced neutrophilia (82.2%), and thrombocytopenia (103 to 144×109/l). All patients had echographic signs of inflammatory transformation of the appendix which was removed on the first day of hospitalization (the first day of the disease) by laparoscopic technique. The examination of the removed biomaterial revealed a tendency to thrombosis in the small vessels of the process and ulcerative changes accompanied by necrosis. There is a discussion of the relationship between the development of gangrenous appendicitis and the clinical course of COVID-19 infection. It is necessary to continue investigations, perform in-depth analysis of the factors causing pathological changes, and to clarify the role of SARS-CoV-2 disease with the aim of preventing the spread of COVID-19. © 2023, Meditsina-Inform LLC. All rights reserved.
ABSTRACT
The second decade of the 21st century started with the emergence of a new coronavirus SARS-CoV-2, affecting humans and causing COVID-19 infection. Children usually have mild disease with one-third of them being asymptomatic, which hinders diagnostics of this infection and does not prevent hospitalization of infected children with non-respiratory disorders to hospitals. Objective. To assess the incidence and specific characteristics of COVID-19 among children emergently admitted to a multidisciplinary hospital not intended for hospitalization of patients with COVID-19. Patients and methods. We performed retrospective analysis of medical records of children admitted to different departments of a multidisciplinary hospital in Moscow between 20.03.2020 and 20.07.2020 (9,779 were discharged during this period). Results. A total of 64 children aged 1 month to 17 years admitted to 10 different departments had positive PCR results for COVID-19 (nasal/oropharyngeal swabs) upon admission to hospital. Fifteen patients (23.4%) had asymptomatic coronavirus infection. These were primarily children of school age and less often of preschool age admitted to the Departments of Traumatology, Surgery with injuries, fractures, exacerbation of chronic nephrological or abdominal disorders. Twenty-four participants (37.5%) presented with mild or none catarrhal symptoms, whereas 12 children were diagnosed with pneumonia. The highest number of SARS-CoV-2-positive children (n = 30;46.9%) were admitted to the Department of Infectious Diseases, as could be expected. Conclusion. Our findings suggest that, in general, the current situation reflects our knowledge about COVID-19. Children usually have mild or asymptomatic COVID-19 and play a significant role in virus transmission, contributing to the continuation of the pandemic. Our results have high clinical and epidemiological significance and require further investigations among children of different ages to accumulate the data. © 2021, Dynasty Publishing House. All rights reserved.