The effect of the covid 19 pandemic on the number of patients treated for acute and complex acute appendicitis.

AIM: The aim of this study was to compare the increase in the number of complicated cases in patients who underwent surgery for acute appendicitis during the COVID-19 pandemic and the previous year. MATERIAL AND METHODS: A retrospective examination was made of the files of patients who presented at the Emergency Department and were diagnosed with acute appendicitis and underwent surgery within 24 hours or were followed up between 11 March and 1 June 2020 during the COVID-19 pandemic, and in the same period in the previous year. The patients in the pandemic period were named the pandemic group (PG) and the patients from the previous year, the control group (CG). The definition of complicated appendicitis included peri-appendicular abscess and perforated appendix. RESULTS: The number of patients in the PG was 38.33% lower than in the CG. The duration of symptoms was 2 days in the PG and 1 day in the CG, and the difference was statistically significant (p=0.001). The mean neutrophil count was determined to be higher in the PG than in the CG (p=0.018). The rate of perforated appendix was determined to be 10.9 higher in the PG than in the CG. CONCLUSION: The number of patients presenting at the Emergency Department reduced during the pandemic, especially during periods of lockdown, and it was seen that fewer but more complicated patients presented at our centre. KEY WORDS: Acute appendicitis, COVID-19, Perforation.

COVID-19 History Increases the Anxiety of Mothers with Children in Intensive Care during the Pandemic in Turkey.

This study aimed to examine the mental status of mothers whose children were hospitalized during the COVID-19 pandemic, especially in places where risk factors are higher such as pediatric intensive care units, and to contribute to the development of psychological health policies, especially for these high-risk groups in epidemic situations. METHOD: This descriptive cross-sectional study was conducted between January 2021 and July 2021. The population of the study was mothers whose children were hospitalized in the pediatric intensive care unit during the study period. Data collection was carried out via a face-to-face interview method by experienced nurses working in pediatric clinics using a sociodemographic data form, the Beck Anxiety Inventory, the Beck Depression Inventory, the Fear of COVID-19 Inventory, and the Coronavirus Anxiety Inventory. RESULTS: The median age of the participants was 33 (min: 21, max: 50). The Beck Anxiety score was affected by the child's diagnosis, location, and history of COVID-19 (* P = 0.011, ** P = 0.018, and *** P = 0.002, respectively). Similarly, the Beck Depression score was affected by the child's diagnosis and history of COVID-19 in a relative (* P = 0.034 and ** P = 0.037, respectively). The Coronavirus Anxiety score was affected by a history of COVID-19 in a relative and work status (* P = 0.040 and ** P = 0.005, respectively), while the Fear of COVID-19 score was not significantly affected by any variable. In a logistic regression model, previous COVID-19 experience was independently associated with anxiety; a history of COVID-19 increased the risk of developing anxiety by approximately 15 times (odds ratio: 14.915, 95% CI: 2.075-107.192). CONCLUSION: When children of mothers with a history of COVID-19 are hospitalized, special attention should be given to their mothers concerning psychological support and assistance.

High Neutrophil/Lymphocyte Ratios in Symptomatic Pediatric COVID-19 Patients.

OBJECTIVE: To investigate the symptoms and laboratory results of children hospitalised with the diagnosis of COVID-19, aiming to reveal the characteristics of symptomatic cases. STUDY DESIGN: A descriptive cross-sectional study. PLACE AND DURATION OF STUDY: Department of Pediatrics, Kastamonu Training and Research Hospital, Kastamonu, Turkey from March to December 2020. METHODOLOGY: Seventy-nine children, hospitalised with the diagnosis of COVID-19, were included in the study and were divided into two groups as symptomatic and asymptomatic. The demographic data, laboratory results and clinics of the patients of the two groups were compared. RESULTS: The mean age of participants was 10.43 ± 5.91 (0-17) years, and 57% (n=45) of them were girls. Five patients in the symptomatic group had comorbidities (2 allergic asthma,  cerebral palsy, type-1 diabetes mellitus and anorexia nervosa). The most common symptom was fever (36.7%, n=29). It was noteworthy that everyone with an NLR >3.13 (high-NLR) was symptomatic. Significantly more patients in the high-NLR group were symptomatic compared with the low-NLR group (p=0.005). On the other hand, symptomatic children had significantly higher levels of C-reactive protein (2.8 (IQR: 1.2-10.0) mg/L vs. 1.4 (IQR: 0.4-2.0) mg/L, p=0.011); and procalcitonin (0.05 (IQR: 0.02-0.10) ng/mL vs. 0.01 (IQR: 0.00-0.03) ng/mL, p<0.001) than those without symptoms. One of the children with cerebral palsy died from pneumonia during the study. CONCLUSION: C-reactive protein, procalcitonin and NLR levels were found to be significantly higher in symptomatic children. NLR can be suggested as a potential marker associated with disease severity in COVID-19 patients, which needs to be supported by other studies. Key Words: COVID-19, Children, Neutrophil / lymphocyte ratio, C-reactive protein, Procalcitonin.