ABSTRACT
BACKGROUND AND AIM: The coronavirus disease 2019 (COVID-19) has deepened the existing health inequalities and has limited access to health services. The aim of this study was to assess the impact of the COVID-19 pandemic on the care of AA in children at a single institution in Sfax, Tunisia. METHOD(S): We divided our patients into two groups: the first (COVID group) included patients who had surgery during covid-19 pandemic (between March 02, 2020, and December 31, 2020), while the second (pre-COVID group) included those who had appendectomy before the pandemic (between March 02, 2019, and December 31, 2019). RESULT(S): A total of 275 patients were included. The COVID-19 group included 136 patients and the pre- COVID-19 group 139 patients. Multivariate logistic analyses revealed that time from onset of abdominal pain to arrival to the emergency department was higher in COVID group patients (36 [24-48] hours vs 30 [12-48] hours, p-value = 0.023). Patients undergoing surgery during the COVID era had a significantly higher Alvarado score (7 [5-8] vs 6 [5-7], p value = 0.002). We have found no differences between the two study groups with respect to outcomes including length of hospital stay, re-admission rate, re-operation rate, and postoperative complications rate. CONCLUSION(S): this is the first study, in Tunisia, to assess the impact covid-19 pandemic on the care of AA in children. We suggest that strategies should be implemented to educate parents and to encourage them to seek for an emergent care of potentially serious conditions such as AA.