Impacts of lockdown during the SARS-CoV-2 pandemic on patients presenting with cervicofacial infection of odontogenic origin: a comparative study

Abstract

Introduction The SARS-CoV-2 pandemic caused unprecedented disruption to primary and secondary healthcare services. Our aim was to explore whether the pandemic had any impact on patients presenting with cervicofacial infections (CFI) of odontogenic origin to the secondary care and their management. Methods Comparative analysis was carried out evaluating prospective and retrospective consecutively admitted patients with a diagnosis of CFI of odontogenic origin in the COVID-19 lockdown period from 15 th March to 15 th June 2020 and pre COVID-19 during the same period of the previous year. Data included patient demographics, co-morbidities, systemic inflammatory response syndrome (SIRS) status on admission, clinical features, prior treatment in primary care, source of referral, SARS-CoV-2 antigen status, treatment received in secondary care, intra-operative findings, and whether escalation of the level of care was required. Results Across both cohorts there were one hundred and twenty-five (125) patients admitted with CFI of odontogenic origin, with a 33% reduction ((n = 75 (2019) vs. n = 50 (2020)) in number of patients admitted during COVID-19 lockdown. There was no difference between the cohorts in terms of age (p = 0.192), gender (p = 0.609) or major co-morbidities (p = 0.654). Proportionally more patients in the COVID-19 group presented with SIRS (p = 0.004). This group of patients persisted with symptoms for longer before presenting to secondary care (p = 0.003), more delay from hospital admission to surgical intervention (p < 0.005) and had longer length of hospital stay (p = 0.001). More patients required extra-oral surgical drainage during COVID-19 (p = 0.056). Conclusions This study suggests that the COVID-19 lockdown has had adverse effects on the presentation of CFI of odontogenic origin and its management within a Regional Acute Maxillofacial Service. Commissioners and clinicians should endeavour to plan for adequate primary and secondary care provision during any future local lockdowns to ensure that patient care is optimised.

Effect of COVID-19 pandemic on orofacial and respiratory infections in ear, nose, and throat and oral and maxillofacial surgery emergency departments: a retrospective study of 7900 patients

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Ludwig's angina in a COVID positive patient—An atypical case report

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