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Suppurative Cervical Infections in Australian Children: A Retrospective Cohort Study Pre- and Post-COVID-19 Pandemic
Isabella Taplin1, Phoebe C M Williams1,2,3,4, Jennifer W Y Lee5
1From the School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia.
Insights
Following COVID-19 nonpharmaceutical interventions (NPIs), Australian children experienced more frequent and severe pediatric cervical infections. This trend, particularly with Streptococcus pyogenes, highlights a shift in infectious disease patterns post-pandemic.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Public Health
Background:
- Pediatric cervical infections, including lymphadenitis and deep neck space infections, pose significant health risks.
- Nonpharmaceutical interventions (NPIs) for COVID-19 impacted childhood infectious disease patterns.
- The study investigates the effect of COVID-19 NPIs on pediatric cervical infections in Australia.
Purpose of the Study:
- To evaluate the influence of COVID-19 nonpharmaceutical interventions (NPIs) on the epidemiology of pediatric cervical infections.
- To compare the incidence, severity, and management of cervical infections before and after the pandemic.
Main Methods:
- Retrospective cohort study at two major Australian pediatric tertiary hospitals.
- Inclusion of children aged 0-16 with suppurative cervical infections (prepandemic: July 2017-June 2019; postpandemic: July 2021-June 2023).
- Analysis of clinical, demographic data, and comparison of pre- and postpandemic cohorts.
Main Results:
- A total of 329 patients were analyzed (150 prepandemic, 179 postpandemic).
- Significant increase in retropharyngeal/parapharyngeal infections post-pandemic.
- Postpandemic infections were more severe, with earlier presentation, larger abscesses, and more aggressive management, notably in Streptococcus pyogenes cases.
Conclusions:
- Relaxation of COVID-19 NPIs correlates with increased incidence and severity of pediatric suppurative cervical infections.
- Findings align with global shifts in pediatric infectious disease epidemiology post-pandemic.
- Highlights the need for continued surveillance and adapted management strategies for pediatric infections.
Background:
Pediatric cervical infections, including cervical lymphadenitis and deep neck space infections, are potentially life-threatening. Nonpharmaceutical interventions (NPIs) implemented to control the COVID-19 pandemic have altered the epidemiology of many infectious diseases in children. This study aimed to assess the impact of NPIs directed against COVID-19 on the epidemiology of cervical infections in an Australian pediatric population.
Methodology:
A retrospective cohort study was conducted at the 2 largest pediatric tertiary hospitals in Sydney, New South Wales, Australia. Children (0-16 years inclusive) with a suppurative cervical infection presenting between July 1, 2017 to June 30, 2019 (prepandemic cohort) and July 1, 2021 to June 30, 2023 (postpandemic cohort) were included. Detailed clinical and demographic data were extracted. Descriptive analyses, including statistical tests of comparison, were performed to compare the pre- and postpandemic cohorts.
Results:
Three hundred twenty-nine patients with cervical infections were included: 150 in the prepandemic cohort and 179 in the postpandemic cohort. There was a significant increase in the number of retropharyngeal/parapharyngeal infections in the postpandemic cohort. Additionally, infections were more severe, with patients presenting earlier to hospital with larger abscesses. Management was also more aggressive, with greater administration of corticosteroids and longer hospital stays. These changes post-COVID-19 were most pronounced in infections caused by Streptococcus pyogenes.
Conclusion:
The relaxation of NPIs directed against COVID-19 appears to correlate with an increased incidence and severity of suppurative cervical infections in Australian. This concurs with the changing epidemiology of infectious diseases in pediatric populations following the pandemic, both within Australia and globally.
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