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Severe Group A Streptococcus Infections in Children During and After the COVID-19 Pandemic: An Interrupted

Alix Flamant1, Hélène Faury2, Romain Luscan3

  • 1From the General Pediatrics and Pediatric Infectious Diseases.

The Pediatric Infectious Disease Journal
|May 29, 2025
PubMed

Insights

Severe Group A Streptococcus (GAS) infections decreased during the early COVID-19 pandemic but surged in the late pandemic. Late pandemic GAS infections were more severe, highlighting the need for preparedness in future pandemics.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Pediatrics

Background:

  • An unusual increase in severe Group A Streptococcus (GAS) infections was observed in 2022-2023.
  • This study investigates changes in GAS infection epidemiology and clinical features during and after the COVID-19 pandemic.

Purpose of the Study:

  • To assess the impact of the COVID-19 pandemic on the incidence and severity of severe GAS infections in children.
  • To compare clinical characteristics of GAS infections across different pandemic phases.

Main Methods:

  • Analysis of severe GAS infections in children admitted to a Paris university hospital from 2018 to 2023.
  • Inclusion of proven and probable invasive GAS (iGAS and piGAS) cases.
  • Time-series analysis to model GAS infection incidence across four periods: pre-pandemic, early pandemic, late pandemic, and post-pandemic.

Main Results:

  • A total of 269 children with severe GAS infections were included; most had severe ear-nose-throat (ENT) infections.
  • GAS infections decreased by 83% in the early pandemic but significantly increased in the late pandemic (IRR 1.65).
  • Late pandemic cases showed increased severity, longer hospital stays, higher rates of iGAS, pleural empyema, bone/joint infections, and complicated ENT infections compared to other periods.

Conclusions:

  • The late COVID-19 pandemic period was characterized by a rise in both the incidence and severity of GAS infections.
  • Findings suggest a need for enhanced preparedness strategies for future pandemics to manage surges in severe GAS infections.
Abstract

Keywords:
COVID-19 pandemicepidemiologyinvasive bacterial infections

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