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COVID-19 and severe ENT infections in pediatric patients. IS there a relationship?
Guillén-Lozada Enrique1, Bartolomé-Benito Margarita1, Moreno-Juara Ángel1
1Otorhinolaryngology Department. Niño Jesus University Children's Hospital, Madrid, Spain.
Insights
Severe ear, nose, and throat infections in children increased during the COVID-19 pandemic. While linked to potential SARS-CoV-2 exposure, a direct causal relationship remains unclear due to limited serological evidence.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Epidemiology
Background:
- Children are susceptible to SARS-CoV-2 infection but typically experience milder illness.
- Pediatric inflammatory conditions, including severe ear, nose, and throat (ENT) infections, have been observed.
- The study investigates a potential link between COVID-19 and severe pediatric ENT infections.
Purpose of the Study:
- To determine the relationship between COVID-19 and severe ear, nose, and throat infections in pediatric populations.
- To analyze the incidence of severe ENT infections in children during the COVID-19 pandemic.
- To assess the association between COVID-19 exposure and complicated pediatric ENT cases.
Main Methods:
- Retrospective compilation of pediatric ENT infections from 2010-2020.
- Analysis of 2020 infection incidence compared to historical data (2010-2019).
- Epidemiological interviews and IgG serological testing for COVID-19 in affected children and contacts.
Main Results:
- A significant outbreak of complicated mastoiditis and deep cervical infections occurred in 2020 (13 patients).
- 54% of these pediatric patients had confirmed or suspected close contact with COVID-19.
- Only 15.4% of children tested positive for IgG antibodies, indicating past SARS-CoV-2 infection.
Conclusions:
- A notable increase in complicated mastoiditis and deep cervical infections was observed in early 2020, coinciding with the COVID-19 pandemic.
- While 54% of cases were linked to COVID-19 contact, low seropositivity (15.4%) prevents establishing a direct causal link.
- Factors like primary care limitations and altered help-seeking behaviors may have contributed to increased complicated infections.
Background:
Preliminary evidence suggests that children are just as likely to become infected with SARS-CoV-2 as adults but are less prone to developing severe clinical conditions. However, there are pediatric inflammatory conditions that have also been encountered. The aim of this report is to determine whether there is a relationship between COVID-19 and severe infections in the ear, nose, throat, and deep cervical area (ENT) in pediatric populations.
Materials And Methods:
A compilation was made of all the cases of ENT area infections in the pediatric population per month attended to at the Niño Jesús University Children's Hospital from January 2010 to June 2020. Endemic channels and dispersion analysis were designed to analyze the incidence presented in the year 2020, compared to what was expected based on historical data from 2010 to 2019. Then, an epidemiological interview was conducted of the close contacts of COVID-19 of the children who presented a severe ENT infection in 2020. Finally, a serological test of IgG antibodies was performed on all of them to find out if they had overcome the COVID- 19.
Results:
620 patients from 1022 were eligible for the study. We observed a significant outbreak in the incidence of complicated mastoiditis and deep cervical infections with complications in the year 2020 (13 patients) linked to the COVID-19 pandemic. From these patients, 54% had been confirmed or had high suspicion of close contact with COVID-19.15.4% of children were positive in serological tests for IgG antibodies.
Conclusion:
There has been a significant increase in mastoiditis and deep cervical infections with complications in the first four months of 2020, which constitutes an outbreak. A considerable number (54%) of these complicated infections were related to close contact with COVID-19. Still, only 15.4% were positive in serological tests for IgG antibodies, so we cannot establish a direct categorical relationship. The limitations in primary care due to a shortage of human resources in dealing with the pandemic's initial onslaught and changes in help-seeking behavior could explain increased complicated infections.
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