Changes in operative otolaryngology infections related to the COVID19 pandemic: A retrospective cohort study

Adeel Sheikh; Chris Capello; Zaid AlMubarak; Agnieszka Dzioba; Peng You; Nancy Nashid; Michelle Barton; Murad Husein; Julie E Strychowsky; M Elise Graham

doi:10.1016/j.ijporl.2023.111650

Changes in operative otolaryngology infections related to the COVID19 pandemic: A retrospective cohort study

Int J Pediatr Otorhinolaryngol. 2023 Aug:171:111650. doi: 10.1016/j.ijporl.2023.111650. Epub 2023 Jul 8.

Authors

Affiliations

¹ Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada.
² Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada.
³ Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Division of Infectious Disease, Department of Pediatrics, London Health Sciences Centre, 800 Commissioners Road E, London, ON, N6A 5W9, Canada.
⁴ Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada. Electronic address: elise.graham@lhsc.on.ca.

PMID: 37437498
DOI: 10.1016/j.ijporl.2023.111650

Abstract

Background: Pediatric emergency admissions fell significantly during the COVID-19 pandemic. This study investigated the changes in severe infectious complications managed by otolaryngology between the pre-pandemic period and the first year of the pandemic to determine if COVID-19 or related public health measures influenced the rate or severity of presentations managed in otolaryngology.

Methods: A retrospective chart review was conducted on pediatric patients who presented with severe infectious otolaryngology presentations (acute mastoiditis, deep neck space abscesses, and orbital complications of sinusitis) over the pre-pandemic (March 2018-February 2020) and early pandemic (March 2020-February 2021) periods. Patient characteristics, details of presentation, treatment, and outcomes were extracted from patients' charts. Independent samples t-tests/Mann-Whitney U-tests for continuous variables and Pearson chi-squared tests/Fisher's exact test for categorical variables were conducted to compare the pre vs early pandemic groups.

Results: There were 93 pre-pandemic and 28 early pandemic presentations. The monthly case average was significantly lower during the early pandemic period than the 2 years prior [3.58 (2.80) vs 2.00 (2.00), P = .045]. The average monthly frequency of presentations for deep neck space abscess and mastoiditis were significantly higher in the pre-pandemic group when compared to the early pandemic group [1.96 (±0.33) vs 1.33 (±0.48), P = .049; .71 (±0.26) vs 0.17 (±0.41), P = .01, respectively]. The early pandemic group was significantly younger (3.81 vs 6.04 years, P = .005), however there were no differences in gender, length of admission, and days from symptom onset to presentation between the two groups (P > .05). The early pandemic group had significantly elevated inflammatory markers on presentation [CRP, WBC, neutrophils (P = .02, P = .02, P = .04, respectively)] compared to the pre-pandemic group.

Conclusion: The COVID-19 pandemic has had an effect on severe infectious complications of ENT pathologies, including decreased average monthly cases during the early pandemic, younger age at presentation, and elevated inflammatory markers.

Keywords: COVID19; Deep space neck abscess; Mastoiditis; Pandemic.

MeSH terms

Abscess / surgery
COVID-19*
Child
Humans
Mastoiditis*
Pandemics
Retrospective Studies