Decreased number of acute appendicitis cases in pediatric population during the COVID-19 pandemic: Any link?
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The reasons behind the decrease in AA frequency during the COVID-19 pandemic remain unclear. Some authors have proposed that milder forms can be treated conservatively at home  or using antibiotics. Snapiri et al. also reported delays in diagnosing AA in seven pediatric patients having complicated forms of AA. We believe that other factors may contribute to the decrease including various infectious agents (viruses, bacteria, fungi and parasites) whose exposure in the pediatric population and a potential link to AA have been proposed. It is also well-known that some of these pathogens may give specific histomorphological forms of AA. During the lockdown period, it is likely that the exposure to various microbes has been substantially reduced and consequently affected the frequency of AA in pediatric population. Regardless the causes and numbers, all pediatric emergencies, including AA, during the COVID-19 pandemic should be promptly treated as any delay in their diagnosis and treatment may be as big of a threat as the COVID-19 virus itself.
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