Otitis Media Practice During the COVID-19 Pandemic

Area of Science:

• Otolaryngology
• Infectious Diseases
• Public Health

Background:

• The COVID-19 pandemic significantly impacted pediatric infectious diseases, including acute otitis media (AOM).
• Pre-pandemic coronaviruses (CoVs) were infrequently detected in AOM cases and associated with mild illness.
• Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emerged as the primary cause of the global pandemic.

Purpose of the Study:

• To analyze the effects of COVID-19 pandemic measures on AOM prevalence and management in children.
• To evaluate the role of telemedicine and surgical interventions during the pandemic.
• To investigate SARS-CoV-2 detection in middle ear fluid and tissues.

Main Methods:

• Review of changes in AOM diagnosis, treatment, and surgical procedures during the pandemic.
• Assessment of telemedicine utilization and its diagnostic accuracy for AOM.
• Analysis of AOM episode rates, spontaneous resolution, and ventilation tube insertion (VTI) surgeries.
• Investigation of SARS-CoV-2 presence in middle ear fluid and post-mortem specimens.

Main Results:

• AOM episodes and VTI surgeries decreased significantly during the pandemic.
• Telemedicine adoption for AOM increased, but diagnostic accuracy and antibiotic prescription rates were concerns.
• High spontaneous resolution rates of middle ear fluid were observed in children.
• SARS-CoV-2 was detected in middle ear fluid of infected patients and in middle ear/mastoid mucosa post-mortem.

Conclusions:

• Pandemic-related public health measures led to reduced AOM incidence and surgical interventions.
• Telemedicine presents challenges in accurate AOM diagnosis and appropriate antibiotic use.
• Myringotomy procedures were deemed safe despite initial concerns about viral shedding.
• Further research is needed on SARS-CoV-2's otologic implications.