Evolution in the incidence of infectious diseases in the pediatric ENT area during the COVID-19 pandemic

Torres-García, Lidia; Acosta, Raúl Mellídez; Cañada-Martínez, Antonio José; Alcañiz, Isabel Ibáñez; Velazquez, Agustín Alamar; Carceller, Miguel Armengot

doi:10.1016/j.otoeng.2022.11.007

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…The COVID-19 pandemic and resulting social isolation had a major impact on the clinical appearance and frequency of AOM and resulting complications. Previous studies have noted a significant change in clinical features, affected population and causative pathogens of pediatric AM during the COVID-19 pandemic (6,7). Smith et al noticed a significant decrease in AM, partly due to the absence of a winter peak, along with shifts in the age of onset (4.7 versus 3.2 yr, respectively) and in the detected pathogens (from S. pneumoniae to Pseudomonas aeruginosa ).…”

Section: Introductionmentioning

confidence: 99%

Tenfold Increase: Acute Pediatric Mastoiditis Before, During, and After COVID-19 Restrictions

Draut,

Müller,

Hempel

et al. 2024

Otol Neurotol

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Introduction Acute mastoiditis (AM) is a relatively rare complication arising from acute otitis media, a common condition among children. The COVID-19 pandemic has significantly impacted AM cases. We noted a surge in pediatric AM cases in Germany after COVID-19 restrictions were lifted in 2022. This study assesses AM incidence and the clinical course in children before, during, and after the pandemic. The study also explores complication rates and microbial changes. Methods Participants: We included children (0–18 yr) diagnosed with AM who underwent mastoidectomy at a tertiary-care university hospital from January 2012 to June 2023. Objectives: We aimed to evaluate AM incidence during pre-COVID, COVID, and post-COVID periods; assess complications; and analyze the microbial spectrum. Data Analysis: Incidence and complication rates were compared between periods, along with the microbial spectrum. Results Population: 75 children were included (median age, 3.3 yr). Incidence: Significant increases in AM cases occurred in the post-COVID period compared to pre-COVID and COVID periods. No significant difference was observed between pre-COVID and COVID periods. Complications: Complication rates increased notably in the post-COVID period compared to pre-COVID and COVID periods with respect to more sensitive imaging methods being used in the post-COVID period. No significant difference was observed between pre-COVID and COVID periods. Spectrum of Pathogens: No significant differences were found in pathogen distribution between periods. Streptococcus pyogenes and Streptococcus pneumoniae were common throughout. Discussion The study highlights a substantial rise in AM cases and complications after COVID-19 restrictions were lifted in Germany. This underscores the importance of monitoring infectious diseases and their complications during health crises. Additionally, the study highlights the importance of contrast-enhanced imaging. Further research is needed to explore the mechanisms behind this trend. Conclusion The study reveals a significant increase in pediatric AM cases and complications following the COVID-19 pandemic in Germany. Adequate computed tomographic or magnetic resonance imaging, including contrast enhancement, is shown to be a very important parameter beside clinical symptoms in deciding for the right therapy. Thus, surgical treatment became more important. Continuous monitoring and adaptive healthcare strategies during health crises are vital for optimal patient care. Further research is warranted to understand the reasons behind these trends and to inform future pandemic preparedness efforts.

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Section: Introductionmentioning

confidence: 99%

Tenfold Increase: Acute Pediatric Mastoiditis Before, During, and After COVID-19 Restrictions

Draut,

Müller,

Hempel

et al. 2024

Otol Neurotol

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Increase in acute mastoiditis at the end of the COVID-19 pandemic

Goldberg-Bockhorn,

Hurzlmeier,

Vahl

et al. 2024

Eur Arch Otorhinolaryngol

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Purpose Common respiratory infections were significantly reduced during the COVID-19 pandemic due to general protective and hygiene measures. The gradual withdrawal of these non-pharmaceutical interventions (NPI) was associated with a notable increase in these infections, particularly in pediatric and adult otorhinolaryngology. The aim of this retrospective monocentric study was to evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM). Methods Pre-pandemic clinical data of AM cases from 2011 to 2019 were compared with infection counts from January 2020 to June 2023 for seasonal periodicity, age-specific differences, pathogens, and complication rates in a German third-level hospital. Results Out of 196 patients with AM 133 were children, the majority between 1 and 5 years of age. Complications of AM, such as meningitis, brain abscess, and sinus vein thrombosis, were more common in adults (87%) than in children (17%). Morbidity and mortality rates were similar before, during and after the pandemic. Pneumococci were the most common pathogen in both age groups, with a post-pandemic cumulation of Streptococcus pyogenes infections in children. While pre-pandemic cases clustered in spring, seasonality was absent in all age groups during the main phase of the pandemic. The cessation of NPI caused a steep rise in AM cases in both age groups starting from December 2022. Conclusion NPI during the COVID-19 pandemic reduced the incidence of AM. Their reversal led to a substantial increase in the incidence of AM during the post-pandemic period, which may be due to a general increase in viral respiratory infections and an insufficiently trained immune system.

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Otorhinogenic intracranial complications in children: Optimization of diagnostics and treatment

Kuznetsova,

Zakharov

2024

Medicinskij sovet

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Introduction. Intracranial complications (IC) of sinusitis and acute otitis media (AOM) in children are rare but life-threatening phenomena. Both intracranial and extracranial complications require early diagnosis and timely interdisciplinary approach to treatment. The article considers data on the prevalence of otorhinogenic complications in children, the possibilities of their early diagnosis, treatment and prognosis at the present stage.Aim. To study the prevalence of otolaryngogenic complications, the possibility of their early diagnosis and prediction of the occurrence of complications in children.Materials and methods. A retrospective analysis of medical records of patients aged ≤ 18 years who were treated in the pediatric otolaryngology department of the Tyumen Regional Clinical Hospital No. 2 from 2013–2023 was performed. A patient database was created, the prevalence of intracranial complications was studied, the significance of clinical, laboratory parameters, and integral blood indices was assessed, and a model for predicting otolaryngogenic intracranial complications was created based on the logistic regression method.Results. A total of 21 495 people were treated over the past period, 233 (1.1%) had verified otogenic complications, 55 (0.3%) had intracranial complications, and 178 (0.8%) had extracranial complications. The average age of children with otogenic intracranial complications (OIC) was 6.3 ± 4.1 years, and rhinogenic intracranial complications (RIC) was 11.3 ± 4.5 years. With Ht ≤ 34.2 and ISL ≥ 3.98, OIC is diagnosed, and with ISL ≥ 4.75, RIC is diagnosed, requiring surgical treatment by an ENT doctor and a neurosurgeon. Using logistic regression, a model for predicting complications was created, the sensitivity of which was 97.6%, specificity – 94.0%, and efficiency – 95.6%. The first-line antibiotic therapy used was penicillin group drugs, including combination drugs with clavulanic acid, as well as cephalosporins.Conclusions. The prevalence of otorhinogenic intracranial complications in children of the Tyumen region was 0.3%. Early diagnostics, prognosis, otorhinogenic complications using integral blood indices and logistic regression is a modern and informative method in pediatric practice. The use of amoxicillin in the form of dispersible tablets as a starting antibacterial therapy in children with uncomplicated acute otorhinolaryngitis has good efficiency due to high bioavailability.

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Evolution in the incidence of infectious diseases in the pediatric ENT area during the COVID-19 pandemic

Cited by 3 publications

References 18 publications

Tenfold Increase: Acute Pediatric Mastoiditis Before, During, and After COVID-19 Restrictions

Tenfold Increase: Acute Pediatric Mastoiditis Before, During, and After COVID-19 Restrictions

Increase in acute mastoiditis at the end of the COVID-19 pandemic

Otorhinogenic intracranial complications in children: Optimization of diagnostics and treatment

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