The Journal of pediatrics · 2025
Sustained Increase in Pediatric Mastoiditis in the Post-COVID-19 Era: A 9-Year Interrupted Time-Series Analysis Based on National Data.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Furgier Apolline, Basmaci Romain, Valtuille Zaba, Fafi Inès, Assad Zein, Lenglart Léa, Teissier Natacha, Benoit Charlotte, Chebib Emilien, Bourmaud Aurélie, Angoulvant François, Crisinel Pierre Alex, Birgy André, Ouldali Naïm, Jaboyedoff Manon
Аннотация
OBJECTIVE: To assess the impact of COVID-19 pandemic-related non-pharmaceutical interventions (NPI) on the incidence of mastoiditis cases, causative pathogens, and associated complications in children.
STUDY DESIGN: We conducted a population-based interrupted time-series analysis using national surveillance data from France between January 2016 and December 2024. All hospitalized mastoiditis cases among individuals younger than 18 years in France were included. The main outcome was the monthly incidence of mastoiditis cases, analyzed using quasi-Poisson regression models, accounting for seasonality.
RESULTS: We included 7390 hospitalized cases of mastoiditis in children. Following a decrease in the incidence of mastoiditis by 58.9% (95% CI: 68.2% to 46.9%, P < .001) during the strict NPI period, we observed an increase of 71.7% (95% CI: 26.4% to 133.3%, P < .001) in the post-NPI period compared with the expected trend without NPI. The proportions of complicated cases and those requiring surgery remained stable over time. By pathogen, the most important increase in the post-NPI period was observed among mastoiditis caused by Streptococcus pyogenes (+627.8%, 95% CI: +269.1% to +1335.0%, P < .001), followed by Streptococcus pneumoniae (+135.6%, 95% CI: +20.5% to +360.6%, P = .012) and Haemophilus influenzae (+124.3%, -17.0% to +506.0%, P = .111).
CONCLUSIONS: In this 9-year population-based national study, we observed a sustained increase in the incidence and etiology of mastoiditis in children during the post-COVID-19 period. We hypothesize that these changes, associated with NPI during the pandemic and lifting postpandemic, reflect consequences that should be considered in the management of future pandemics.
STUDY DESIGN: We conducted a population-based interrupted time-series analysis using national surveillance data from France between January 2016 and December 2024. All hospitalized mastoiditis cases among individuals younger than 18 years in France were included. The main outcome was the monthly incidence of mastoiditis cases, analyzed using quasi-Poisson regression models, accounting for seasonality.
RESULTS: We included 7390 hospitalized cases of mastoiditis in children. Following a decrease in the incidence of mastoiditis by 58.9% (95% CI: 68.2% to 46.9%, P < .001) during the strict NPI period, we observed an increase of 71.7% (95% CI: 26.4% to 133.3%, P < .001) in the post-NPI period compared with the expected trend without NPI. The proportions of complicated cases and those requiring surgery remained stable over time. By pathogen, the most important increase in the post-NPI period was observed among mastoiditis caused by Streptococcus pyogenes (+627.8%, 95% CI: +269.1% to +1335.0%, P < .001), followed by Streptococcus pneumoniae (+135.6%, 95% CI: +20.5% to +360.6%, P = .012) and Haemophilus influenzae (+124.3%, -17.0% to +506.0%, P = .111).
CONCLUSIONS: In this 9-year population-based national study, we observed a sustained increase in the incidence and etiology of mastoiditis in children during the post-COVID-19 period. We hypothesize that these changes, associated with NPI during the pandemic and lifting postpandemic, reflect consequences that should be considered in the management of future pandemics.