Increase in Pediatric Perforated Appendicitis in the New York City Metropolitan Region at the Epicenter of the COVID-19 Outbreak

During the COVID-19 surge in New York City (March-May 2020), children with appendicitis had significantly higher perforation rates (45% vs 27%) and longer symptom duration compared to five years of historical controls, suggesting pandemic-related healthcare disruption delayed timely surgical care. SARS-CoV-2 infection status itself did not worsen outcomes, indicating the primary harm was delayed presentation rather than direct viral effects.