Has COVID-19 Affected the Course of Chickenpox in Children?

Area of Science:

• Pediatrics
• Infectious Diseases
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted public health, potentially altering the course of common childhood infections like chickenpox.
• Understanding these changes is crucial for pediatric infectious disease management and public health strategies.

Purpose of the Study:

• To evaluate the effect of the COVID-19 pandemic on chickenpox (varicella) epidemiology and clinical presentation in children.
• To analyze trends in chickenpox complications and associated pathogens before, during, and after the pandemic.

Main Methods:

• Retrospective analysis of medical records for 350 children under 18 hospitalized with chickenpox between January 2018 and December 2023.
• Data collection included patient demographics, clinical course, complications, and microbiological findings.

Main Results:

• Chickenpox hospitalizations were lowest during the pandemic, increasing significantly in 2023.
• Bacterial dermatitis and lower respiratory tract infections were the most common complications (84.86%).
• Post-pandemic, a rise in generalized inflammatory reactions and invasive *Streptococcus pyogenes* infections (41.46% of skin lesions) was noted, with 5.90% requiring surgery. Gastrointestinal symptom hospitalizations decreased significantly post-pandemic.

Conclusions:

• The post-pandemic period saw an increase in severe bacterial skin infections and generalized inflammatory reactions in pediatric chickenpox cases, potentially linked to increased invasive group A streptococcal infections.
• Enhanced hygiene practices adopted during the pandemic contributed to a significant reduction in chickenpox cases presenting with gastrointestinal symptoms.