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Observational Study
. 2022 Jan;47(1):120-130.
doi: 10.1111/coa.13869. Epub 2021 Nov 3.

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study

Matthew E Smith  1 , G Huw Jones  2 , John C Hardman  3 , Jaya Nichani  4 , Sadie Khwaja  5 ; INTEGRATE (The UK ENT Trainee Research Network) UK Acute Paediatric Mastoiditis Audit Collaborators; Iain A Bruce  6 , Peter Rea  7
Collaborators, Affiliations
Observational Study

Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study

Matthew E Smith et al. Clin Otolaryngol. 2022 Jan.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Clin Otolaryngol. 2022 Jul;47(4):552. doi: 10.1111/coa.13937. Clin Otolaryngol. 2022. PMID: 35695026 Free PMC article. No abstract available.

Abstract

Objectives: To explore the impact of COVID-19 on the management and outcomes of acute paediatric mastoiditis across the UK.

Design: National retrospective and prospective audit.

Setting: 48 UK secondary care ENT departments.

Participants: Consecutive children aged 18 years or under, referred to ENT with a clinical diagnosis of mastoiditis.

Main outcome measures: Cases were divided into Period 1 (01/11/19-15/03/20), before the UK population were instructed to reduce social contact, and Period 2 (16/03/20-30/04/21), following this. Periods 1 and 2 were compared for population variables, management and outcomes. Secondary analyses compared outcomes by primary treatment (medical/needle aspiration/surgical).

Results: 286 cases met criteria (median 4 per site, range 0-24). 9.4 cases were recorded per week in period 1 versus 2.0 in period 2, with no winter increase in cases in December 2020-Febraury 2021. Patient age differed between periods 1 and 2 (3.2 vs 4.7 years respectively, p < 0.001). 85% of children in period 2 were tested for COVID-19 with a single positive test. In period, 2 cases associated with P. aeruginosa significantly increased. 48.6% of children were scanned in period 1 vs 41.1% in period 2. Surgical management was used more frequently in period 1 (43.0% vs 24.3%, p = 0.001). Treatment success was high, with failure of initial management in 6.3%, and 30-day re-admission for recurrence in 2.1%. The adverse event rate (15.7% overall) did not vary by treatment modality or between periods 1& 2.

Conclusion: The COVID-19 pandemic led to a significant change in the presentation and case mix of acute paediatric mastoiditis in the UK.

Keywords: COVID; acute mastoiditis; antibiotic; paediatric; surgery.

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Figures

FIGURE 1
FIGURE 1
Incidence and total case number of acute paediatric mastoiditis before and after the UK introduction of COVID‐19 measures (periods: 01/11/19‐15/03/20 and 16/03/20‐30/04/21)
FIGURE 2
FIGURE 2
Age distribution of children presenting with acute mastoiditis in Period 1 (01/11/19‐15/03/20) and Period 2(16/03/20‐30/04/21)
FIGURE 3
FIGURE 3
Type of non‐medical management, as a percentage of all subjects, before (light grey bars) and after (dark grey bars) the introduction of COVID‐19 measures in the UK. Bonferroni‐corrected P‐value for comparison of paired bars
See this image and copyright information in PMC

References

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