Pediatric Invasive Group A Streptococcus Characteristics Before, During, and After COVID-19

Pediatric invasive Group A Streptococcus (iGAS) infections two years before, during, and a year after the Coronavirus Disease 2019 (COVID-19) pandemic were analyzed in an urban hospital in the Northeastern United States. Invasive GAS was diagnosed in 38 patients. There were as many infected children post-COVID as in the prior 4.5 years combined. The post-pandemic surge was most striking in late spring. The median age was youngest during the post-pandemic year at 2.3 years. During and after the pandemic, about half the children had concurrent virus detection, and two-thirds had no known chronic comorbidities, highlighting Streptococcus pyogenes' potential for significant morbidity in healthy and young children. The spectrum of iGAS disease manifestations was similar among the 3 time periods, with soft tissue infections predominating overall. Of post-pandemic GAS isolates, 67% were emm1 and 33% were emm12. Preventive efforts of this grave disease at all ages should continue.