Seasonal variation and demographic characteristics of acute tonsillitis and peritonsillar abscess in ENT practices in Germany (2019-2023).

OBJECTIVE

Peritonsillar abscess (PTA) is a common soft tissue infection of the head and neck. It remains unclear to what extent inflammatory diseases of the palatine tonsils or other infections contribute to the development of PTA. This study examines the demographic characteristics and seasonal variations of acute tonsillitis (aT) and PTA in ENT practices in Germany using a practice database.

METHODS

Retrospective analysis based on data from the German-wide IQVIA Disease Analyzer database for the period 2019 to 2023. Data include diagnoses of aT (ICD-10: J03) and PTA (ICD-10: J36) as well as patient demographics (age, sex). Seasonal variations were identified by analysing the monthly diagnosis rates. The Pearson correlation between the monthly case numbers of aT and PTA was determined.

RESULTS

59,934 cases of aT and 5,024 cases of PTA were recorded. The mean age was 30.3 years (aT) and 39.4 years (PTA). The proportion of female patients was 60% (aT) and 49% (PTA). Both diagnoses showed seasonal variations with peaks in winter and spring and a decline in summer, although the decline was less pronounced for PTA. The monthly case numbers of aT and PTA showed high correlations between r = 0.75 (2019) and r = 0.94 (2020). The average correlation for the period 2019-2023 was r = 0.81. During the coronavirus pandemic, a significant decrease in the case numbers of both diseases was observed, while the typical seasonal variations disappeared. After the pandemic, the case numbers increased to higher levels than before the pandemic.

CONCLUSIONS

aT and PTA both show seasonal variations with peaks in winter and spring and a decline in summer. The correlation between the variations of aT and PTA could be related to a partly common aetiology or to the specific sample of the practice database. The attenuation of seasonal variation during the coronavirus pandemic illustrates the impact of COVID-19 on the incidence of other diseases and on the use of healthcare pathways by patients.