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Rate of Pediatric Appendiceal Perforation at a Children’s Hospital During the COVID-19 Pandemic Compared With the Previous Year

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Clinicians have witnessed a dramatic shift in health care consumption during the coronavirus disease 2019 (COVID-19) pandemic as patients fear exposure to coronavirus from visiting health care facilities.1,2 Among the many concerning patterns emerging is that of delayed medical care. Garcia et al3 reported a 38% decline in cardiac ST-segment elevation myocardial infarction activations, and Teo et al4 noted fewer patients with ischemic stroke presenting within the therapeutic window. Lazzerini et al5 described 12 children who presented in severe condition because of delays in accessing care; 4 of these children died.

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Article Information

Accepted for Publication: September 24, 2020.

Published: December 4, 2020. doi:10.1001/jamanetworkopen.2020.27948

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Place R et al. JAMA Network Open.

Corresponding Author: Rick Place, MD, MHA, Department of Emergency Medicine, Inova Fairfax Medical Campus, 3300 Gallows Rd, Falls Church, VA 22042 (frederick.place@inova.org).

Author Contributions: Dr Place had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Place, Howell.

Acquisition, analysis, or interpretation of data: Place, Lee.

Drafting of the manuscript: Place.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Howell.

Supervision: Place.

Conflict of Interest Disclosures: None reported.

References
1.
Saad  L . Americans worry doctor visits raise COVID-19 risk. Gallup. Published April 6, 2020. Accessed June 18, 2020. https://news.gallup.com/poll/307640/americans-worry-doctor-visits-raise-covid-risk.aspx
2.
Masroor  S .  Collateral damage of COVID-19 pandemic: delayed medical care.   J Card Surg. 2020;35(6):1345-1347. doi:10.1111/jocs.14638 PubMedGoogle ScholarCrossref
3.
Garcia  S , Albaghdadi  MS , Meraj  PM ,  et al.  Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic.   J Am Coll Cardiol. 2020;75(22):2871-2872. doi:10.1016/j.jacc.2020.04.011 PubMedGoogle ScholarCrossref
4.
Teo  KC , Leung  WCY , Wong  YK ,  et al.  Delays in stroke onset to hospital arrival time during Covid-19.   Stroke. 2020;51(7):2228-2231. doi:10.1161/STROKEAHA.120.030105PubMedGoogle ScholarCrossref
5.
Lazzerini  M , Barbi  E , Apicella  A , Marchetti  F , Cardinale  F , Trobia  G .  Delayed access or provision of care in Italy resulting from fear of COVID-19.   Lancet Child Adolesc Health. 2020;4(5):e10-e11. doi:10.1016/S2352-4642(20)30108-5 PubMedGoogle ScholarCrossref
6.
Metzler  B , Siostrzonek  P , Binder  RK , Bauer  A , Reinstadler  SJ .  Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage.   Eur Heart J. 2020;41(19):1852-1853. doi:10.1093/eurheartj/ehaa314 PubMedGoogle ScholarCrossref
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