Pre-operative risk assessment for COVID-19 in pediatric patients

The risks posed by surgery in pediatric patients and the precautions to be taken during the COVID-19 pandemic have not been adequately studied. In this study, it was aimed to establish a method to determine the risk in this patient group and to investigate the effectiveness of this method. The research was conducted between 05.03.2021 and 30.07.2021 in IUC-Cerrahpasa Medical Faculty, Department of Pediatric Surgery. The research is prospective, descriptive and cross-sectional. All patients who met the study criteria and gave consent within the date range determined for this unit were included in the study.SPSS, for Windows 21.0 statistical package program was used in the evaluation of the data, chi-square and Fisher-exact tests were used for comparisons. Kappa and McNemar tests were used to evaluate the PCR result and symptom association, and p<0.05 was considered significant. Considering the positive results of the COVID-19 PCR test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of the form were calculated. As a result; Of the 236 patients included in the study, 31 (13.1%) were diagnosed with COVID-19. Eight of these cases (8/31: 25.8%) had no symptoms (asymptomatic). There was no significant relationship between age groups, gender and the diagnosis of COVID-19. In the child, cough, runny nose, nausea-vomiting, malaise, and in family members fever, cough, myalgia, dyspnea, headache, lack of taste/smell were found to be highly correlated with the diagnosis of COVID-19 (p < 0.001). The presence of a person diagnosed with a diagnosis of COVID-19, contact/suspicion of COVID-19 and quarantine or respiratory system disease in the family in the last 14 days was found to be significantly associated with the diagnosis of COVID-19 (p< 0.001). When the diagnostic values are examined; detection of any symptoms in the child; sensitivity: 74.2%, specificity: 91.7%, PPV: 57.5%. NPV: 91.7%, three or more findings; sensitivity: 25.8% specificity: 100%, PPV: 100%, NPV: 89.9%, and positive response to any question on the form; sensitivity: 83%, specificity: 81.9% PPV: 41.2% NPV: 97.1%. As a result, it has been seen that this method is very effective in investigating the risk of COVID-19 in children before surgery. Larger questionnaires can be developed to detect asymptomatic cases. Such inquiry forms can be useful for applications such as telemedicine. Keywords: COVID-19, Pediatric Surgery, Risk Factors, Risk Assesment Form