(1039) Incidence of Pediatric Peritonsillar Abscess During the COVID-19 Pandemic

Introduction: Peritonsillar abscess (PTA) represents the most prevalent deep space infection within the head and neck, commonly manifesting in older children and adolescents. In response to the COVID-19 pandemic, various public health interventions were implemented to mitigate the spread of infection. This study aims to explore whether there was a concurrent decrease in PTA incidence during this period, thus providing insight into the two possible etiological theories.

Methods: Utilizing the TriNetX database, patients aged 17 years or younger were searched for with CPT codes for evaluation and management (with or without an ICD-10 diagnosis code) of PTA between January 2015 to December 2022. Monthly incidence of peritonsillar abscess (PTA) was recorded during this period. Demographics, history of tonsillitis, and history of tonsillectomy were tabulated for each group. A Wilcoxon rank-sum test was used to compare PTA incidence before lockdown (January 2015 - February 2020) with incidence from the start of lockdown to the lifting of the mask mandate (March 2020 - February 2022). Fisher exact tests were used to analyze categorical variables. Statistical significance was defined as p < 0.05.

Results: Among 8,721,428 identified children, 4,146 had PTA, 2,068 (49.9%) female and 2,043 (49.2%) male. The mean age at the time of PTA diagnosis was 8.1 years (SD = 4.2). Compared to those without PTA, PTA patients were more likely to have a history of acute upper respiratory infection (p < 0.001), specifically acute tonsillitis (p < 0.001), and less likely to have a history of tonsillectomy with or without adenoidectomy (p < 0.001). Median PTA incidence was lower during the pandemic compared to the pre-pandemic period (p < 0.001).

Conclusions: There was a decrease in pediatric PTA incidence during the COVID-19 pandemic, and PTA patients were more likely to have tonsillitis. These findings provide support for the theory that PTA is a complication of tonsillitis.