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

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.

Citation

Smith, M. E., Jones, G. H., Hardman, J. C., Nichani, J., Khwaja, S., INTEGRATE (The UK ENT Trainee Research Network) UK Acute Paediatric Mastoiditis Audit Collaborators, Bruce, I. A., & Rea, P. (2022). Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery, 47(1), 120–130. https://doi.org/10.1111/coa.13869

DOI

10.1111/coa.13869

URI

https://hdl.handle.net/20.500.14709/623

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