Appendicitis and COVID-19: new challenges in a pandemic era

L.V. Feklisova¹, E.B. Olkhova^2,3, S.V. Nikolaeva⁴, E.V. Kanner⁴, I.S. Allakhverdiyev^{3 1}M.F. Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow

²A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow

³St. Vladimir Children’s City Clinical Hospital, Moscow

⁴Central Research Institute of Epidemiology of the Russian Federal Service for Supervision of Consumer

Rights Protection and Human Well-Being, Moscow A variety of clinical symptoms caused by damage both to the respiratory system and other organs characterizes COVID-19. Difficulties in establishing the diagnosis of COVID-19 are explained by the absence of pathognomonic manifestations, including those of the respiratory tract. Difficulties in diagnosis increase in cases of this infection with abdominal pain syndrome, simulating acute appendicitis. The article presents literature data on the clinical picture of COVID-19 in gastrointestinal tract (GIT) disorder. The article also describes the pathogenetic patterns of COVID-19, which can explain the recorded changes and symptoms; evidence of direct damage to intestinal epithelial cells. Particular attention is paid to the possible additional role of microbiota changes in the diarrhea development in patients with COVID-19 (by reduction of colonization resistance, production decrease of beneficial microbial metabolites, and trigger of local immune restructuring).  A clinical case of a male patient with COVID-19 (detected during laboratory examination) is presented without respiratory failure and signs of respiratory disease with phlegmonous appendicitis, with mild course because of the timely and adequate treatment.

Keywords: coronavirus infection, COVID-19, children, appendicitis, acute abdominal syndrome.

For citation: Feklisova L.V., Olkhova E.B., Nikolaeva S.V. et al. Appendicitis and COVID-19: new challenges in a pandemic era. RMJ. 2022;5:12–16.