Acute paediatric mastoiditis in the UK before and during the COVID‐19 pandemic: A national observational study. (3rd November 2021)

• Record Type: Journal Article
• Authors: Smith, Matthew E.; Jones, G. Huw; Hardman, John C.; Nichani, Jaya; Khwaja, Sadie; Bruce, Iain A.; Rea, Peter
• Other Names: Dewhurst Samuel investigator.; Whitehall Emma J investigator.; Donaldson Gavin investigator.; Siddiqi Noshin investigator.; Wooles Nicola investigator.; Gopala Krishnan Srinish investigator.; Selwyn David investigator.; Constable James D investigator.; Wong Billy investigator.; Yousef Ahmed investigator.; Yu Beverley investigator.; McClenaghan Fiona investigator.; Mowat Andrew investigator.; Elmorsy Mohamed investigator.; Brimioulle Marina investigator.; Sakagiannis Georgios investigator.; Mattias Bassem investigator.; Kenyon Olivia investigator.; Kaleva Anna I investigator.; Harrison Anna investigator.; Mathew Elizabeth investigator.; Wright Oliver J investigator.; Steven Richard A investigator.; Collins Rachael investigator.; Yap Darren investigator.; Sethukumar Priya investigator.; Ghasemi Aria Amir investigator.; Conybeare Alison investigator.; Jama Guled M. investigator.; Liu Alison investigator.; Li Lucy Qian investigator.; Gomati Anas investigator.; Flynn William investigator.; Connon Christopher investigator.; Oh Soo investigator.; Wright Brendan investigator.; James McCaffer Craig investigator.; R Lancer Hannah investigator.; Lowe Emily investigator.; Chew Dylan investigator.; Ioannidis Dimitrios investigator.; Herman Anastasha investigator.; Zubair Arshad investigator.; Forde Cillian T investigator.; Watts Emma investigator.; Loroch Anna investigator.; Burton Laura investigator.; Yao Alexander investigator.; Emerson Hannah investigator.; Sarwar Safdar investigator.; Ali Faiza investigator.; Bance Manohar L investigator.; Krishnan Madhankumar investigator.; Smyth Cathy investigator.; Spencer Cheka investigator.; Takwoingi Yohanna investigator.; Strachan David investigator.; Robinson Philip J investigator.; Harding Laura investigator.; Temple Robert investigator.; Dugar Jayant investigator.; Nash Robert investigator.; Janjua Arshad investigator.; Thomas George investigator.; Bottrill Ian investigator.; Vijendren Ananth investigator.; Singh Pranay investigator.; Hunt Alison investigator.; Mitchell‐Innes Alistair investigator.; Spielmann Patrick M investigator.; Phillips John investigator.; Supriya Mrinal investigator.; Majithia Anooj investigator.; Sproson Eleanor investigator.; Lee Patrick investigator.; Kumar Gaurav investigator.; Nair Dilip investigator.; Sharma Alok investigator.; Wynne David investigator.; Kumar Bhimrao Sanjiv investigator.; Jackson Conor investigator.; McLarnon Claire investigator.; Weller Matthew investigator.; Geyer Marcel investigator.; Gupta Sanjeev investigator.; Mitchell Timothy investigator.; Khalid‐Raja Mamoona investigator.; Seymour Kay investigator.; Shaida Azhar investigator.; Hoskison Emma investigator.; Iyer Arunachalam investigator.; Hall Andrew investigator.; Simmons Mark investigator.; Allam Ahmed investigator.; Moore Phillip investigator.;
• Is Part Of: Clinical otolaryngology. Volume 47:Number 1(2022)
• Page Start: 120
• Page End: 130
• Publication Date: 2021-11-03
• Subjects: acute mastoiditis -- antibiotic -- COVID -- paediatric -- surgery; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.13869
• Languages: English
• ISSNs: 1749-4478

Abstract

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.