Acute Paediatric Mastoiditis in the UK Before and During the COVID-19 Pandemic: A National Observational Study

Smith, Matthew; Jones, G. Huw; Hardman, John; Nichani, Jaya; Khwaja, Sadie; HERE, . INSERT COLLABORATOR LIST; Bruce, Iain; Rea, Peter

doi:10.22541/au.163253284.44570038/v1

Cited by 7 publications

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“…A reduction in pediatric acute mastoiditis cases has also been reported by several authors (28,29). In contrast, a Spanish study showed that, although there was no increase in ear, nose, and throat infections from January to April 2020 (a period encompassing also months before COVID in Spain) when compared with the same period in 2010 to 2019, there was a significant increase in complicated mastoiditis cases (e.g., subperiosteal abscess, facial nerve paralysis, intracranial abscess) (15).…”

Section: Discussionsupporting

confidence: 68%

Trends in Pediatric Acute Otitis Media Burden During the First COVID-19 Year

et al. 2022

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ObjectiveTo study the changes in acute otitis media (AOM) pediatric emergency department (PED) visits and pediatric admission before and during the first coronavirus disease 2019 (COVID-19) year.Study DesignRetrospective case review.SettingSecondary care center.PatientsChildren younger than 18 years with all-cause and AOM-related PED visits and pediatric admissions for 3 years (March 1, 2018–January 28, 2021) were identified. Children were categorized according to age (0–2, 2–6, and 6–18 yr) and their date of presentation: pre–COVID-19 (yearly average of visits/admissions during the 2 prepandemic years: March 1, 2018–February 28, 2019 and March 1, 2019–February 29, 2020) or COVID-19 year (visits/admissions between March 1, 2020–February 28, 2021).InterventionPre– and post–COVID-19 emergence, alternating lockdowns, kindergarten and school closures, and increased hygiene measures.Main Outcome MeasurePost– versus pre–COVID-19 AOM PED visit and pediatric admission incidence rate ratios (IRRs), using a generalized estimating equation model with a negative binomial regression calculation, while controlling for monthly fluctuations.ResultsAnnual AOM visits/admissions during the pre–COVID-19 and COVID-19 years were 517 and 192 and 256 and 94, respectively (p < 0.05 for both). For children aged 0 to 2 years, AOM visits/admissions significantly decreased during the first COVID-19 year, compared with the pre-COVID years (β = −1.11 [IRR, 0.33; 95% confidence interval [CI], 0.26–0.42; p < 0.005] and β = −1.12 [IRR, 0.33; 95% CI, 0.25–0.42; p < 0.005]). Relatively to all-cause of children aged 0 to 2 years, AOM visits/admissions decreased during the first COVID-19 year versus the pre–COVID-19 years (β = −2.14 [IRR, 0.12; 95% CI, 0.08–0.17; p < 0.005] and β = −1.36 [IRR, 0.26; 95% CI, 0.23–0.29; p < 0.005]) and had monthly fluctuations coinciding with the lockdown/relaxation measures. For children aged 2 to 6 years, the reduction in AOM admissions was significant (β = −1.70, IRR, 0.18; 95% CI, 0.09–0.37; p < 0.005). No significant differences were observed for children aged 6 to 18 years because of the small sample size.ConclusionPediatric AOM burden substantially decreased during the first COVID-19 year.

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Section: Discussionsupporting

confidence: 68%

Trends in Pediatric Acute Otitis Media Burden During the First COVID-19 Year

et al. 2022

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“…Over the last several decades, the incidence rate of mastoiditis, which closely related to hearing problems, as a complication of NPC has not signi cantly decreased, and our study showed that this incidence rate was still 35.6% [4,7]. NPC patients with mastoiditis often have tinnitus, hearing loss, swelling, pain, and other symptoms, which greatly impacts the quality of life in those patients [26,32,33]. Therefore, a therapeutic approach to prevent/treat NPC-caused mastoiditis is urgently needed.…”

Section: Discussionmentioning

confidence: 94%

Increased Incidence of Mastoiditis in Nasopharyngeal Carcinoma following Anti-PD-1 Therapy: A Propensity-Matched Analysis

Liu

Wen

Zhang

et al. 2022

Preprint

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Background Mastoiditis can be triggered by radiotherapy and is closely associated with hearing loss. We aimed to explore the incidence rate of mastoiditis in locally advanced nasopharyngeal carcinoma (LANPC) patients following anti-programmed death 1 (PD-1) therapy. Methods Patients with primary locoregionally advanced nasopharyngeal carcinoma who were treated with intensity-modulated radiotherapy (IMRT) and concurrent cisplatin-based chemotherapy with or without anti-PD-1 therapy between from January 2020 to January 2022 in one medical facility were retrospectively reviewed. Group A received neoadjuvant chemotherapy (NACT) + concurrent chemoradiotherapy (CCRT) + anti-PD-1 therapy, while Group B did not receive anti-PD-1 therapy. A propensity score matching (PSM) method was used to match patients from each group in a 1:1 ratio. Severity of mastoiditis was evaluated by magnetic resonance imaging (MRI), specifically, mastoid opacification was graded from mild to severe on a scale of 0–3. Results In total, 146 out of 259 eligible patients were propensity matched, with 73 patients in Group A and 73 patients in Group B. No significant differences were observed in the patient and tumor characteristics between Group A and Group B. There were no significant differences between the two groups for the incidence rates of severe mastoiditis before NACT, before CCRT and 0 month following CCRT; while the incidence rates of severe mastoiditis 3, 6 months following CCRT in the Group A versus Group B were 34.2% versus 20.5% (p = 0.044), 37.7% versus 21.9% (p ＜ 0.001), were significance different respectively. The analysis of variance (ANOVA) with repeated measures showed that anti-PD-1 therapy (p = 0.031) significantly increased the incidence rate of severe mastoiditis in LANPC patients compared to that of immunotherapy-free patients following CCRT (p < 0.001). Conclusions LANPC patients following anti-PD-1 therapy experienced severe mastoiditis with an increased probability.

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“…There was not an equivalent rise in acute mastoiditis during the winter peak of AOM in January 2020. In addition, a national UK observation study of acute paediatric mastoiditis during COVID‐19 showed only one positive patient (0.9%) 13 . This suggests a low risk of otological complications from AOM in COVID‐19 patients.…”

Section: Discussionmentioning

confidence: 96%

Ten‐year prevalence of acute hospital ENT infections and the impact of COVID: A large population study

Mettias

Jenkins

Rea

2022

Clinical Otolaryngology

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Background Acute ear, nose and throat (ENT) infections were the commonest referrals from accident and emergency to ENT services. The referral rate changed dramatically with season, year, national outbreaks and during the COVID pandemic. Method Retrospective longitudinal study of the epidemiology of seven acute ENT infections in secondary care over 10 years. A mixed city and rural population of over 650 000 in central England was studied. The risk factors for each wave of infection during the surge of infection were sought. A statistical analysis of their significance was undertaken. This included analysis and correlation of group A‐beta haemolytic streptococcus (GABHS) in hospital and community. Seasonal variations, hospital admissions and the impact of the COVID were analysed. Results There were 16 883 reported cases of the seven index ENT infections during the 10‐year period. Great seasonal and year‐to‐year variations were recorded. There was an incremental rise in 2018. Spring had the highest season of acute ENT infections. An outbreak of GABHS was noted in the community in 2014. The mean duration of hospital admission was 1.5 days. There was no statistical ethnic or gender predominance. A dramatically lower number of acute ENT infections were recorded during the COVID‐19 pandemic, and this continued after lifting of lockdown restrictions. Conclusion A resurgence in scarlet fever directly and indirectly contributed to an incremental rise in acute ENT infections in the following years. Both hospital and community B‐haemolytic cultures have declined during the COVID‐19 pandemic due to a reduction in infections as opposed to reduced case ascertainment.

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Acute Paediatric Mastoiditis in the UK Before and During the COVID-19 Pandemic: A National Observational Study

Cited by 7 publications

References 0 publications

Trends in Pediatric Acute Otitis Media Burden During the First COVID-19 Year

Trends in Pediatric Acute Otitis Media Burden During the First COVID-19 Year

Increased Incidence of Mastoiditis in Nasopharyngeal Carcinoma following Anti-PD-1 Therapy: A Propensity-Matched Analysis

Ten‐year prevalence of acute hospital ENT infections and the impact of COVID: A large population study

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