Author/Authors :
Motazedian, Gholamreza Plastic & Reconstructive Surgery Department - Shiraz University of Medical Sciences, Shiraz, Iran , Aryanpoor, Poorya Jahrom University of Medical Sciences, Jahrom, Iran , Rahmanian, Ehsan Research center for social Determinants of Health - Jahrom University of Medical Sciences, Jahrom, Iran , Abiri, Samaneh Research center for social Determinants of Health - Jahrom University of Medical Sciences, Jahrom, Iran , Kalani, Navid Research center for social Determinants of Health - Jahrom University of Medical Sciences, Jahrom, Iran , Hatami, Naser Jahrom University of Medical Sciences, Jahrom, Iran , Bagherian, Farhad Department of Emergency Medicine - Babol University of Medical Sciences, Babol, Iran , Etezadpour, Mohammad Surgery department - Faculty of Medicine - Mashhad University of Medical sciences, Mashhad, Iran , Farzaneh, Roohie Department of Emergency Medicine - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Maleki, Fatemeh Department of Emergency Medicine - Faculty of Medicine - Birjand University of Medical Sciences, Birjand, Iran , Foroughian, Mahdi Department of Emergency Medicine - Faculty of Medicine - Mashhad University of Medical Sciences, Mashhad, Iran , Ghaedi, Mojtaba Plastic Surgery department - Jahrom University of Medical Sciences, Jahrom, Iran
Abstract :
Introduction: COVID-19 has affected the pattern of referral to medical centers and quarantine against COVID-
19 might delay referral and management of surgical emergencies. This study aimed to compare the pooled
event rate of pediatric perforated appendicitis before and during the COVID-19 pandemic. Methods: This was
a systematic review and meta-analysis study based on the PRISMA guidelines. Scopus, Web of Sciences, and
PubMed databases were searched for studies reporting the rate of perforated appendicitis based on the post-
appendectomy observations or imaging methods. The Egger bias test and funnel plot were used to detect and
depict publication bias. Statistical analysis was performed in Comprehensive Meta-analysis package version 3.
Results: Twelve studies were eligible for inclusion in our study. The pooled prevalence of pediatric perforated
appendicitis in the pre-COVID era was 28.5% (CI95%: 28.3 to 28.7%) with a heterogeneity of 99%. In the COVID
era, the event rate proportion was 39.4% (CI95%: 36.6 to 42.3%) with a heterogeneity of 99%. There was a sig-
nificant difference in the subgroup analysis within the pre-COVID and COVID era (P<0.001), showing a higher
perforation rate in the COVID era. Conclusion: Our study showed that during the COVID-19 pandemic, the rate
of perforated appendicitis has significantly increased in comparison to before the COVID-19 pandemic.
Keywords :
COVID-19 , Appendicitis , Ruptured , Abdomen , Acute
