Otorhinolaryngology Department. Niño Jesus University Children's Hospital, Madrid, Spain.
Otorhinolaryngology Department. Niño Jesus University Children's Hospital, Madrid, Spain.
Int J Pediatr Otorhinolaryngol. 2021 Jun;145:110714. doi: 10.1016/j.ijporl.2021.110714. Epub 2021 Apr 16.
Preliminary evidence suggests that children are just as likely to become infected with SARS-CoV-2 as adults but are less prone to developing severe clinical conditions. However, there are pediatric inflammatory conditions that have also been encountered. The aim of this report is to determine whether there is a relationship between COVID-19 and severe infections in the ear, nose, throat, and deep cervical area (ENT) in pediatric populations.
A compilation was made of all the cases of ENT area infections in the pediatric population per month attended to at the Niño Jesús University Children's Hospital from January 2010 to June 2020. Endemic channels and dispersion analysis were designed to analyze the incidence presented in the year 2020, compared to what was expected based on historical data from 2010 to 2019. Then, an epidemiological interview was conducted of the close contacts of COVID-19 of the children who presented a severe ENT infection in 2020. Finally, a serological test of IgG antibodies was performed on all of them to find out if they had overcome the COVID- 19.
620 patients from 1022 were eligible for the study. We observed a significant outbreak in the incidence of complicated mastoiditis and deep cervical infections with complications in the year 2020 (13 patients) linked to the COVID-19 pandemic. From these patients, 54% had been confirmed or had high suspicion of close contact with COVID-19.15.4% of children were positive in serological tests for IgG antibodies.
There has been a significant increase in mastoiditis and deep cervical infections with complications in the first four months of 2020, which constitutes an outbreak. A considerable number (54%) of these complicated infections were related to close contact with COVID-19. Still, only 15.4% were positive in serological tests for IgG antibodies, so we cannot establish a direct categorical relationship. The limitations in primary care due to a shortage of human resources in dealing with the pandemic's initial onslaught and changes in help-seeking behavior could explain increased complicated infections.
初步证据表明，儿童感染 SARS-CoV-2 的可能性与成年人一样大，但不太容易出现严重的临床症状。然而，也出现了一些儿科炎症性疾病。本报告的目的是确定 COVID-19 是否与儿科人群的耳部、鼻部、喉部和深部颈部区域（ENT）的严重感染有关。
对 2010 年 1 月至 2020 年 6 月期间，在 Niño Jesús 大学儿童医院每月就诊的儿科人群 ENT 区域感染病例进行了汇编。设计了地方性渠道和分散分析，以分析 2020 年呈现的发病率，与 2010 年至 2019 年的历史数据相比。然后，对 2020 年出现严重 ENT 感染的 COVID-19 儿童的密切接触者进行了流行病学访谈。最后，对所有儿童进行了 IgG 抗体的血清学检测，以了解他们是否已克服 COVID-19。
在 1022 名患者中，有 620 名符合研究条件。我们观察到 2020 年复杂乳突炎和深部颈部感染发病率显著上升，并伴有并发症（13 例），与 COVID-19 大流行有关。这些患者中有 54%被确诊或高度怀疑与 COVID-19 有密切接触。15.4%的儿童 IgG 抗体血清学检测呈阳性。
2020 年的前四个月，复杂性乳突炎和深部颈部感染并伴有并发症的发病率显著增加，构成了一次爆发。相当数量（54%）的复杂感染与 COVID-19 的密切接触有关。然而，只有 15.4%的 IgG 抗体血清学检测呈阳性，因此我们不能建立直接的因果关系。由于大流行初期人力资源短缺以及寻求帮助行为的改变，初级保健受到限制，这可能解释了复杂性感染的增加。
