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Trends in Timing and Provision of Pediatric Cochlear Implant Care During COVID-19
Kimberley S Noij1, Emily Y Huang1, Jonathan Walsh1
1Department of Otolaryngology-Head and Neck Surgery Johns Hopkins University School of Medicine Baltimore Maryland USA.
Insights
The COVID-19 pandemic caused significant delays in cochlear implant (CI) care for children with prelingual deafness. Patients experienced longer waits for evaluation and surgery, and fewer rehabilitation visits post-implantation.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted healthcare systems globally.
- Understanding its impact on specialized pediatric care, such as cochlear implantation, is crucial.
Purpose of the Study:
- To analyze trends in the timing of pediatric cochlear implant (CI) care during the COVID-19 pandemic.
- To compare care milestones between pre-pandemic and pandemic periods.
Main Methods:
- A retrospective cohort study compared pediatric CI patients before (1/1/2016-2/29/2020) and during (3/1/2020-12/31/2021) the COVID-19 pandemic.
- Key intervals analyzed included diagnosis to evaluation, evaluation to surgery, and postoperative rehabilitation visits.
Main Results:
- Patients with prelingual deafness faced longer evaluation-to-surgery intervals during the pandemic (47.3 weeks vs. 20.5 weeks, p<.001).
- The COVID-19 group had fewer in-person rehabilitation visits post-surgery (14.9 vs. 20.9, p=.04).
- Average age at implantation increased during the pandemic (5.7 years vs. 3.7 years, p=.05).
Conclusions:
- Pediatric cochlear implant care, particularly for prelingual deafness, experienced significant delays during the COVID-19 pandemic.
- These delays may impact long-term outcomes and highlight the need for resilient healthcare strategies.
Objectives:
To identify trends in timing of pediatric cochlear implant (CI) care during COVID-19.
Study Design:
Retrospective cohort.
Setting:
Tertiary care center.
Methods:
Patients under 18 years of age who underwent CI between 1/1/2016 and 2/29/2020 were included in the pre-COVID-19 group, and patients implanted between 3/1/2020 and 12/31/2021 comprised the COVID-19 group. Revision and sequential surgeries were excluded. Time intervals between care milestones including severe-to-profound hearing loss diagnosis, initial CI candidacy evaluation, and surgery were compared among groups, as were the number and type of postoperative visits.
Results:
A total of 98 patients met criteria; 70 were implanted pre-COVID-19 and 28 during COVID-19. A significant increase in the interval between CI candidacy evaluation and surgery was seen among patients with prelingual deafness during COVID-19 compared with pre-COVID-19 (µ = 47.3 weeks, 95% confidence interval [CI]: 34.8-59.9 vs µ = 20.5 weeks, 95% CI: 13.1-27.9; p < .001). Patients in the COVID-19 group attended fewer in-person rehabilitation visits in the 12 months after surgery (µ = 14.9 visits, 95% CI: 9.7-20.1 vs µ = 20.9, 95% CI: 18.1-23.7; p = .04). Average age at implantation in the COVID-19 group was 5.7 years (95% CI: 4.0-7.5) versus 3.7 years in the pre-COVID-19 group (95% CI: 2.9-4.6; p = .05). The time interval between hearing loss confirmation and CI surgery was on average 99.7 weeks for patients implanted during COVID-19 (95% CI: 48.8-150) versus 54.2 weeks for patients implanted pre-COVID (95% CI: 39.6-68.8), which was not a statistically significant difference (p = .1).
Conclusion:
During the COVID-19 pandemic patients with prelingual deafness experienced delays in care relative to patients implanted before the pandemic.
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