Incidence of pediatric tonsillitis, otitis and upper respiratory infectious entities in the pre and post COVID-19 quarantine eras

Abstract

Background

At this point of the COVID-19 pandemic, with the worldwide loosening of health restrictions, there has been an observed jump in infectious load especially of the upper airways.

Aims/Objectives: To shed light on children’s immunity and potential health risks after the COVID-19 pandemic.

Methods

A retrospective chart review from May 2019 to January 2022. Pediatric patients with a discharge diagnosis suggestive of an upper respiratory or ENT infection were included. The sample was divided into three groups according to the date of presentation.

Results

A total 4356 patients were diagnosed with ENT infectious aetiology. The mean age was 4.69 years. The three periods studied were: Period-1 (May 2019–January 2020), period-2 (February 2020–April 2021) and period-3 (May 2021–January 2022). The distribution of adenoiditis and MEE is the same across all periods (p > .05). The incidence of URTI, AOM and tonsillitis were significantly highest during period-3 followed by period-1, which in turn was significantly higher than during period-2 (p < .05). The incidence of sinusitis was the highest during period-3 (p < .001).

Conclusion

There seems to be a heightened susceptibility to acute infection in children after the pandemic.

Significance: It is important to keep in mind the changes in microbiota and implement measures to promote healthy gut flora, timely vaccination, and prompt medical interventions.

1. Summary Box

   What is already known: We already know that quarantine has significantly decreased infectious load especially in children.

2. This study adds an objective assessment of this decrease with an assessment of the infectious load post-quarantine.

3. This study is a model for future pandemics on the importance of vaccinations and the importance of microbiota changes after pandemics.

Chinese Abstract

背景：在 COVID-19 大流行的这一阶段, 随着全球健康限制的放松, 我们观察到感染量激增, 尤其是上呼吸道。

目的：阐明 COVID-19大流行之后儿童的免疫力和潜在的健康风险。

方法：2019 年 5 月 至 2022 年 1 月的回顾性图表分析。纳入出院诊断提示为上呼吸道或耳鼻喉感染的儿童患者。 根据就医日期将患者分为三组。

结果：共有4356例患者确诊为耳鼻喉感染病因。 平均年龄是4.69岁。 研究的三个阶段是：阶段 1（2019 年 5 月至 2020 年 1 月）、阶段 2（2020年2 月至2021年4月）和阶段3（2021年5月至2022年1月）。 腺样体炎和MEE的分布在所有阶段都相同 (p>.05)。 URTI、AOM 和扁桃体炎的发生率显然在第 3阶段最高, 其次是第 1 阶段；第 1 阶段又显著高于第 2 阶段 (p<.05)。 鼻窦炎的发生率在第 3 阶段最高 (p<.001)。

结论：COVID-19大流行之后儿童急性感染的易发性似乎更大。

意义：时刻提醒自己微生物群在不断变化, 采取措施促进健康的肠道菌群, 及时接种疫苗, 并及时采取医疗干预措施, 这些都很重要。

Keywords:

• URTI
• otitis
• tonsillitis
• sinusitis
• vaccination
• COVID-19

Ethical consideration

This study was approved by the Institutional Ethics Committee Institutional Review Board at the American University of Beirut) (Protocol number: BIO-2022-0165). The research was conducted ethically, with all study procedures being performed in accordance with the requirements of the World Medical Association’s Declaration of Helsinki. Written informed consent was waived in accordance with ethical standards.

Author contributions

CAZD was involved in idea planning, proposal write-up, data collection, manuscript writing, and data analysis. YY, AD, PF and WN were involved in data collection. RB was responsible to oversee the project and editing the manuscript.

Disclosure statement

All authors declare that they have no conflicts of interest.

Data availability statement

The datasets generated during and/or analysed during the current study are available from the corresponding author upon reasonable request.