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The Impact of COVID-19 Pandemic on Pediatric Surgery
Over the past year, the worldwide novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has led to a major global socioeconomic burden and challenged health care systems. This had forced clinicians and researchers to examine new clinical management protocols and possible effects of the pandemic to clinical practice. The entire medical educational system, especially surgical training, has been gravely impacted and led to the need of new methods of education and meeting platforms. The purpose of this review block is to give an overview of the current literature on the impact of COVID-19 pandemic on pediatric surgery, including guidelines on workflow pathways, pediatric appendicitis, virtual education, and the bench-to-bedside potential of current translational research.
Iacona et al review the current guidelines on workflow pathways for pediatric surgical teams during the COVID-19 pandemic. The review brings clear guideline-based step-by-step approaches to pediatric surgical emergency procedures, in a case of suspected or confirmed SARS-CoV-2-positive patient, and overall surgical team pathways. The review shows that the guidelines are used successfully during pandemic for pediatric theater teams and could be adapted to management beyond pandemic.
Saalabian et al provide a comprehensive update on the incidence, presentation, and management of pediatric appendicitis during the COVID-19 pandemic. Despite a worrying trend toward late presentation during COVID-19 pandemic, most patients with acute appendicitis have comparable outcomes to prepandemic era. Testing for COVID-19 is considered to be imperative in all children presenting with acute appendicitis like symptoms to differentiate COVID-19-related multisystem inflammatory syndrome, masking acute appendicitis and avoiding unnecessary surgery.
Aubert et al describe how the pandemic has accelerated the already existing trend of virtual education and online conferences. Remote access has become routine to ensure continued and accessible education regardless of time and space. These new platforms facilitate the worldwide connection and interaction of trainees and pediatric surgeons and will be part of the future beyond pandemic.
Zani-Ruttenstock et al review the most updated literature on exosomes, small extracellular vesicles that mediate intercellular communication, and stem-cell paracrine mechanisms in COVID-19. Exosomes seem to play an important role in the pathogenesis of SARS-CoV-2 infection. Furthermore, exosomes may serve as potential agents for treatment, prevention, and diagnosis of COVID-19. Multiple ongoing studies are underway to evaluate exosomes as diagnostic tools, therapeutic agents, and vaccine carriers for COVID-19. The lessons learned using exosomes for COVID-19 will help determine their efficacy and applicability in other clinical conditions.
This review block provides up-to-date evidence on the impact of COVID-19 on pediatric surgical practice during and beyond the pandemic. We hope that the accumulated knowledge and lessons learned will support the readers to improve clinical practice, educational activities, and stimulate collaborative research.
09 July 2021 (online)
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- 1 Iacona R, Chima K, Kotecha A, Saxena A. surgical perspectives for pediatric theater teams during the SARS-CoV-2 pandemic and beyond: narrative review and mandatory tasks guidelines. Eur J Pediatr Surg 2021; 31 (04) 305-310
- 2 Saalabian K, Rolle U, Friedmacher F. Impact of the global COVID-19 pandemic on the incidence, presentation, and management of pediatric appendicitis: lessons learned from the first wave. Eur J Pediatr Surg 2021; 31 (04) 311-318
- 3 Aubert O, Wagner R, Gerardo R, Tamaro G, Zani A, Ponsky T, Lacher M. Virtual education in pediatric surgery during the COVID-19 era: facing and overcoming current challenges. Eur J Pediatr Surg 2021; 31 (04) 319-325
- 4 Zani-Ruttenstock E, Antounians L, Khalaj K, Figueira RL, Zani A. The role of exosomes in the treatment, prevention, diagnosis, and pathogenesis of COVID-19. Eur J Pediatr Surg 2021; 31 (04) 326-334