Pediatric Parapneumonic Empyema: Trends in the Post-COVID-19 Era in Northern India

Introduction  The coronavirus disease 2019 (COVID-19) pandemic disrupted immunization services, and regular checkups were hampered, as the entire health infrastructure was focused on the management of the COVID-19 pandemic. During the pandemic, infectious diseases decreased because of a number of factors. This study was conducted to investigate changes in the incidence of empyema cases in the post-COVID-19 era, in comparison to pre-COVID-19 times. Methods This was an ambispective observational study of all cases of thoracic empyema admitted under the Department of Pediatrics in the Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India, over a period of one and a half years, from June 2023 to December 2024, after the COVID-19 pandemic ended. The objectives were to evaluate the clinical characteristics, outcomes, and frequency of empyema cases after the COVID-19 pandemic. Patients aged 1 month to 14 years with pneumonia and empyema were included. Demographic and clinical parameters, presence of any comorbid illnesses, nutritional status, details of investigations, and other relevant information were collected in a predesigned case record form. Results The percentage of empyema cases during the study period was 0.56%. The majority of patients were below five years of age. Pneumonia was the most common predisposing factor. The percentage of tuberculosis empyema cases was also higher than in earlier periods; culture positivity was low, and fibrinolytics were used in a higher percentage of patients. Conclusions In this region, in post-COVID-19 times, the rate of pediatric parapneumonic empyema cases has decreased. The use of intrapleural fibrinolytic therapy (IFT) has increased, and surgical intervention can often be avoided if fibrinolytic therapy is used promptly.