Background: Pneumococcal antibody deficiency has been the subject of limited study in chronic rhinosinusitis (CRS) and has not been studied in recurrent acute rhinosinusitis (RARS). The 23-valent pneumococcal polysaccharide vaccine (PPSV23) is considered for patients with nonprotective Streptococcus pneumoniae titers. We hypothesized that both RARS and CRS patients with deficient S pneumoniae titers and subsequent PPSV23 vaccination would have reduced health-care encounters for sinusitis and fewer prescriptions for antibiotics or steroids. Methods: A retrospective cohort study was performed of patient encounters between January 2011 and December 2019. All patients included were ≥18 and ≤65 years old with a diagnosis of CRS or RARS and pneumococcal titer data.Patients with immunodeficiency and comorbid conditions requiring PPSV23 vaccination before 65 years of age were excluded. Results: A total of 938 patients were included in the study. Nonprotective antibody titers were present in 75.8% of CRS and 74.8% of RARS patients. A total of 306 patients with deficient antibody titers received the PPSV23 vaccine. Eighty-nine percent of CRS and 90.1% of RARS patients had protective responses. Among the 217 patients with continuous data from 2 years before through 2 years after PPSV23 vaccination, a decrease in the number of encounter diagnoses of CRS (p < 0.0001) and RARS (p = 0.0006) was observed. Decreases in the frequency of antibiotic (p = 0.002) and corticosteroid (p = 0.04) prescriptions were also appreciated. Conclusion:Most patients with CRS and RARS have nonprotective antibody titers. PPSV23 administration significantly decreases health-care utilization.

Objectives: This study reviews patients aged 21 and younger, who presented to the Ochsner Medical Center's Pediatric Emergency Department during the COVID-19 pandemic. A retrospective analysis was completed comparing demographics, symptomology, and laboratory analysis between COVID positive and negative patients.Methods: This study examined pediatric patients presenting to the Pediatric Emergency Department at Ochsner Medical Center between March 11 and May 20, 2020. All children included in the study underwent COVID-19 testing via nasopharyngeal swab. Demographic and clinical information was collected through chart review of electronic medical records, and the Fisher Exact Test was utilized in statistical analysis to determine if clinical characteristics influenced COVID-19 test results in a meaningful way.Results: In our experiment, 160 patients were included based on symptomatology consistent with COVID-19 infection, and 22 (13.8%) resulted positive. The following variables significantly influenced the COVID-19 test to result positive: Ages 11-18 (p < 0.001), exposure to sick contact (p < 0.001), neurologic symptoms (p = 0.001), and anosmia (p = 0.009). Characteristics which significantly influenced CO-VID-19 tests to result negative were ages 1-4 (p = 0.040), and White race (p = 0.048). Within the cohort, 6 COVID positive patients necessitated hospital admission, 3 of whom were admitted to the PICU. All 3 PICU admits displayed symptoms of shock, consistent with Multisystem Inflammatory Syndrome in Children (MIS-C). Conclusion:We found COVID-19 infection rate in children to be 13.8%, which is consistent with national data. We found significant associations between COVID positivity and anosmia, neurologic symptoms, sick contacts and 11-18 year-old age group. COVID negativity was significantly associated with 1-4 year-old age group and White race. While long-term effects from COVID19 are not yet known, our study showed overall flu-like symptoms and no deaths. Yet, Black adolescent patients may be at risk for more severe disease. Continued efforts towards studying transmission and prevention of COVID in children are needed.