Volume 33, Issue 2 (6-2026)
J Transl Med Res. 2026, 33(2): 123-134 |
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Ethics code: IR.UMSU.REC.1404.196
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Khosravi R, Alizadeh H. Comparison of pathology reports and paraclinical indices in pediatrics appendectomies before and during the COVID-19 pandemic. J Transl Med Res. 2026; 33 (2) :123-134
URL: http://journal.bums.ac.ir/article-1-3606-en.html
URL: http://journal.bums.ac.ir/article-1-3606-en.html
1- Department of Pediatric Diseases, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2- Department of Pediatric Diseases, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran ,hatef.aliz@gmail.com
2- Department of Pediatric Diseases, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran ,
Abstract: (276 Views)
Background and Aims: Acute appendicitis is the most common cause of emergency surgery in children. The COVID-19 pandemic, by altering patient referral patterns, delaying access to healthcare services, and changing clinical decision-making, may affect clinical and laboratory characteristics as well as the rate of negative appendectomies. This study aimed to compare pathology reports and paraclinical indices of paediatric appendectomies before and after the COVID-19 pandemic.
Materials and Methods: This retrospective descriptive-analytical study was conducted on 200 children aged 6 months to 16 years who underwent appendectomy and were admitted to Shahid Motahari Hospital in Urmia, Iran. Demographic data, length of hospital stay, laboratory indices (white blood cell count [WBC], neutrophil and lymphocyte percentages, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], hemoglobin, and hematocrit), sonography results, and pathology reports were extracted and compared. Statistical analysis was performed using non-parametric tests, Spearman correlation, cluster analysis, and ordinal logistic regression.
Results: Mean age was similar between the two groups (P = 0.739). Hospital stay was significantly shorter during the pandemic (P = 0.027). WBC, neutrophil percentage, ESR, and CRP were significantly lower in the pandemic group (P < 0.05), while lymphocyte percentage increased (P = 0.008). The rate of negative appendectomy (vermiform appendix) decreased from 39% to 33% (P = 0.482). Complicated appendicitis (gangrenous/perforated) increased from 9% to 17% (P = 0.477; non-significant). Ordinal logistic regression showed that WBC was the strongest predictor of appendicitis severity.
Conclusion: The COVID-19 pandemic was associated with significant alterations in laboratory indices. Integration of laboratory findings with clinical evaluation and imaging modalities may help reduce unnecessary surgeries. Multicentre prospective studies are recommended to confirm these findings.
Materials and Methods: This retrospective descriptive-analytical study was conducted on 200 children aged 6 months to 16 years who underwent appendectomy and were admitted to Shahid Motahari Hospital in Urmia, Iran. Demographic data, length of hospital stay, laboratory indices (white blood cell count [WBC], neutrophil and lymphocyte percentages, erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], hemoglobin, and hematocrit), sonography results, and pathology reports were extracted and compared. Statistical analysis was performed using non-parametric tests, Spearman correlation, cluster analysis, and ordinal logistic regression.
Results: Mean age was similar between the two groups (P = 0.739). Hospital stay was significantly shorter during the pandemic (P = 0.027). WBC, neutrophil percentage, ESR, and CRP were significantly lower in the pandemic group (P < 0.05), while lymphocyte percentage increased (P = 0.008). The rate of negative appendectomy (vermiform appendix) decreased from 39% to 33% (P = 0.482). Complicated appendicitis (gangrenous/perforated) increased from 9% to 17% (P = 0.477; non-significant). Ordinal logistic regression showed that WBC was the strongest predictor of appendicitis severity.
Conclusion: The COVID-19 pandemic was associated with significant alterations in laboratory indices. Integration of laboratory findings with clinical evaluation and imaging modalities may help reduce unnecessary surgeries. Multicentre prospective studies are recommended to confirm these findings.
Keywords: COVID-19, Inflammatory markers, Negative appendectomy, Pathology, Pediatric appendectomy, Sonography
Type of Study: Original Article |
Subject:
Pediatrics
Received: 2026/04/17 | Accepted: 2026/06/5 | ePublished: 2026/06/5
Received: 2026/04/17 | Accepted: 2026/06/5 | ePublished: 2026/06/5
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