Peer-reviewed article
Epidemiological and Clinical Changes in Pediatric Acute Mastoiditis Before and After the COVID-19 Pandemic: An Eight-Year Retrospective Study from a Tertiary-Level Center.
Marco Sarno, Antonia Pascarella, Antonietta De Lucia, Pietro Spennato, Fabio Savoia et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared cases of acute mastoiditis (a serious ear infection complication) in children before, during, and after the COVID-19 pandemic at an Italian children's hospital between 2017 and 2024. Hospital admissions for this condition increased more than threefold in 2024 compared to pre-pandemic years, with more children developing serious complications like blood clots and infections in the brain cavity. Surgical procedures increased by 88.5%, and children stayed in hospital longer and needed longer antibiotic treatment after the pandemic.
Key points
- Hospital admissions for acute mastoiditis in children increased more than threefold in 2024 compared with pre-COVID-19 years
- Absolute numbers of complications, especially intracranial complications such as thrombosis and empyema, increased in the post-COVID-19 period
- The rate of surgical procedures increased during the post-COVID-19 period with an overall increase of 88.5%
- Both duration of antibiotic therapy and hospital stay were significantly longer in the post-COVID-19 period
- Study included 276 children aged 1-177 months across eight years at a tertiary-level hospital in Italy
Limitations
The study is descriptive and retrospective, comparing time periods without establishing causal mechanisms for why acute mastoiditis increased after COVID-19. The findings are from a single tertiary hospital in Italy and may not generalize to other settings or populations.
Abstract
Background: Acute mastoiditis is the most frequent suppurative complication of acute otitis media in children. AM can lead to both extracranial complications and intracranial complications. Recent studies suggest an increase in cases after the COVID-19 pandemic. Objective: To compare the epidemiological and clinical characteristics of pediatric patients diagnosed with acute mastoiditis admitted to Santobono-Pausilipon Children's Hospital before and after COVID-19. Methods: We conducted a retrospective study including all patients aged 0-16 years with AM admitted to our hospital between January 2017 and December 2024. Patients were stratified into three groups: pre-COVID-19: 1 January 2017-28 February 2020; COVID-19: 1 March 2020-31 December 2021; and post-COVID-19: 1 January 2022-31 December 2024. Demographic data, clinical presentations, complications, laboratory findings, and treatment modalities were analyzed and compared between groups. Results: A total of 276 children (153 males and 123 females; median age: 49 months, age range: 1-177 months) were included. Hospital admissions for AM increased in the post-COVID-19 period, reaching more than a threefold increase in 2024 compared with the pre-COVID-19 years. Similar to the overall number of AM cases, the absolute number of complications, especially IC, such as thrombosis and empyema, increased. The rate of surgical procedures increased during the post-COVID-19 period, with an overall increase of 88.5%. Both the duration of antibiotic therapy and hospital stay were significantly longer in the post-COVID-19 period. Conclusions: The COVID-19 pandemic has been associated with epidemiological and clinical changes in pediatric AM patients. These findings highlight the need for effective preventive strategies, including enhanced vaccination coverage and the promotion of early diagnosis. Additionally, implementing standardized clinical protocols could support more efficient and consistent management, reducing hospital stays and recurrence rates.