Complications of Pediatric Rhinosinusitis in the COVID-19 Era

Monday, September 30, 2024

2:48 PM – 2:54 PM EDT

Location: MBCC, 225

Disclosure(s):

Amrita N. Bhat, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Johnny C. Wang, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Judith E. Lieu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The incidence of pediatric sinusitis and its complications have changed since the onset of COVID-19, however, these changes are not well characterized. We evaluated trends in the incidence and characteristics of complicated rhinosinusitis in children with respect to the COVID-19 pandemic.

Methods: We reviewed 83 patients treated at St. Louis Children’s Hospital with complicated rhinosinusitis from 2017-2022. Clinical and follow-up data were analyzed by association with COVID-19.

Results: 43 patients were identified with complicated rhinosinusitis in January 2017- February 2020 (Pre-COVID), and 40 were identified in March 2020 through December 2022 (COVID). No significant differences in demographic variables were found between the two groups. 17% had developmental comorbidities in the COVID group compared to 2% in the pre-COVID group (p = 0.049). Complications included orbital cellulitis, orbital abscess, meningitis, epidural or subdural abscess/empyema, Pott’s puffy tumor and cavernous sinus thrombosis. There were more patients with intracranial complications and Pott’s puffy tumor in the COVID era but these differences were not statistically significant. In the COVID group, 45% had Streptococcus anginosus in their surgical cultures versus 21% in the pre-COVID group. Patients with Strep anginosus were more likely to have been given oral steroids before admission (p =0.03). The incidence of complicated sinusitis mirrored the incidence of all viral cases at SLCH, particularly in 2021 and 2022. The incidence of complicated sinusitis was found to peak earlier and extend for longer into the spring and early fall season during 2021-2022, aligning with the increase in COVID cases during this time.

Conclusions: Trends in complicated sinusitis vary before and after the onset of the COVID-19 pandemic. We observed an increased incidence in intracranial complications and Pott’s puffy tumor after March 2020. The incidence of complicated sinusitis during COVID peaked earlier and lasted longer compared to before COVID.

Presenting Author(s)

Amrita N. Bhat, BS

Medical Student
Washington University School of Medicine in St. Louis
Los Altos, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

JW

Johnny C. Wang, BS

Medical Student
Division of Pediatric Otolaryngology, Washington University School of Medicine
St. Louis, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

DM

David W. Molter, MD

Washington University
St Louis, Missouri, United States

Disclosure information not submitted.
MM

Maithilee D. Menezes, MD

Associate Professor
Washington University in St. Louis
St Louis, MO, United States

Disclosure information not submitted.
Kate Dunsky, MD

Associate Professor
Division of Pediatric Otolaryngology, Washington University School of Medicine
Saint Louis, MO, United States

Disclosure information not submitted.
Judith E. Lieu, MD

Professor, Vice-Chair
Washington University
Saint Louis, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.