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Increase in acute mastoiditis at the end of the COVID-19 pandemic
Eva Goldberg-Bockhorn1, Clara Hurzlmeier2, Julius M Vahl2
1Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Frauensteige 12, 89075, Ulm, Germany. eva.goldberg@uniklinik-ulm.de.
Purpose:
Common respiratory infections were significantly reduced during the COVID-19 pandemic due to general protective and hygiene measures. The gradual withdrawal of these non-pharmaceutical interventions (NPI) was associated with a notable increase in these infections, particularly in pediatric and adult otorhinolaryngology. The aim of this retrospective monocentric study was to evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM).
Methods:
Pre-pandemic clinical data of AM cases from 2011 to 2019 were compared with infection counts from January 2020 to June 2023 for seasonal periodicity, age-specific differences, pathogens, and complication rates in a German third-level hospital.
Results:
Out of 196 patients with AM 133 were children, the majority between 1 and 5 years of age. Complications of AM, such as meningitis, brain abscess, and sinus vein thrombosis, were more common in adults (87%) than in children (17%). Morbidity and mortality rates were similar before, during and after the pandemic. Pneumococci were the most common pathogen in both age groups, with a post-pandemic cumulation of Streptococcus pyogenes infections in children. While pre-pandemic cases clustered in spring, seasonality was absent in all age groups during the main phase of the pandemic. The cessation of NPI caused a steep rise in AM cases in both age groups starting from December 2022.
Conclusion:
NPI during the COVID-19 pandemic reduced the incidence of AM. Their reversal led to a substantial increase in the incidence of AM during the post-pandemic period, which may be due to a general increase in viral respiratory infections and an insufficiently trained immune system.
Insights
Non-pharmaceutical interventions (NPI) during COVID-19 significantly reduced acute mastoiditis (AM) cases. Their removal led to a sharp increase in AM incidence, particularly in children, possibly due to increased viral infections and a less-trained immune system.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Epidemiology
Background:
- Non-pharmaceutical interventions (NPI) during the COVID-19 pandemic reduced common respiratory infections.
- The withdrawal of NPI has been linked to increased respiratory infections, especially in otorhinolaryngology.
- Acute mastoiditis (AM) is a significant ear infection requiring study regarding pandemic-related influences.
Purpose of the Study:
- To evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM).
Main Methods:
- Retrospective study comparing pre-pandemic (2011-2019) and pandemic/post-pandemic (2020-2023) data.
- Analysis included seasonal patterns, age-specific differences, pathogens, and complication rates.
- Data collected from a German third-level hospital.
Main Results:
- 196 AM cases analyzed; 133 were children (1-5 years old).
- AM complications were more frequent in adults (87%) than children (17%).
- Post-pandemic, a rise in AM cases occurred after NPI cessation, with *Streptococcus pyogenes* noted in children.
Conclusions:
- NPI effectively reduced AM incidence during the COVID-19 pandemic.
- Reversal of NPI led to a substantial increase in AM incidence.
- This rise may be linked to increased viral respiratory infections and reduced immune system training.
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