[Healthcare aspects of peritonsillar infection before and during the COVID-19 pandemic]

Abstract

Introduction: This study assessed if the healthcare system overload and the organizational changes made in response to COVID-19 may be having an impact on clinical and epidemiological characteristics of the peritonsillar infection (PTI).

Materials and methods: In a retrospective longitudinal and descriptive follow-up, we reviewed the circumstances of the patients attended during 5 years, from 2017 to 2021, in two hospitals, one regional and other tertiary. Variables related to underlying pathology, history of tonsillitis, time of evolution, previous visits to Primary Care, diagnostic findings, abscess/phlegmon ratio, and length of hospital stay were recorded.

Results: From 2017 to 2019, the incidence of the disease ranged between 14 and 16 cases/100,000 inhabitants-year, and decreased to 9.3 in 2020, a 43% less. Patients with PTI consulting in pandemic time were visited much less often in Primary Care services. They showed a greater severity of symptoms and the period of time between their appearance and diagnosis was longer. Additionally, there were more abscesses and the need for hospital admission greater than 24 h was 66%. There was hardly a causal relationship with acute tonsillitis, although 66% of the patients evidenced history of recurrent tonsillitis, and 71% concomitant pathology. All these findings showed statistically significant differences with the pre-pandemic cases.

Conclusions: The protection of airborne transmission, the social distancing and the lockdown adopted in our country are measures that seem having been able to modify the evolution of PTI, with a much lower incidence, a longer recovery period and a minimal relationship with acute tonsillitis.

Keywords: COVID-19; ENT emergency; Epidemiology; Pandemic; Peritonsillar infection; Primary health.

Figura 1

Recta de regresión lineal y ecuación obtenida al correlacionar las variables cuantitativas «N.^o ítems clínicos» (abscisas) y «N.^o de días con clínica previos al diagnóstico» (ordenadas) durante el período comprendido entre 2017 y 2021, ambos inclusive. Tendencia positiva sin significación estadística.

Figura 2

Recta de regresión lineal y ecuación obtenida al correlacionar las variables cuantitativas «N.^o ítems clínicos» (abscisas) y «N.^o de días con clínica previos al diagnóstico» (ordenadas) en el año 2020, primero de pandemia en España. Tendencia positiva y estadísticamente significativa.

Figura 3

Recta de regresión lineal y ecuación obtenida al correlacionar las variables cuantitativas «N.^o ítems clínicos» (abscisas) y «N.^o de días con clínica previos al diagnóstico» (ordenadas) en el año 2021, segundo de pandemia en España. Tendencia positiva sin significación estadística.