Increase in the age of onset of pediatric acute otitis media after the Covid-19 pandemic: A study at a primary emergency medical center.

BACKGROUND

During the coronavirus disease 2019 (Covid-19) pandemic, rigorous infection control measures led to a decrease in the incidence of various infectious diseases. In this study, we investigated the clinical characteristics of acute otitis media (AOM) children during the post-Covid-19 period at a primary emergency medical center.

METHODS

We retrospectively reviewed children with AOM who visited Kobe Children's Primary Emergency Medical Center between April 2017 and March 2024. Patients with AOM or suppurative otitis media were included. We defined each fiscal year (FY) as the period from April to the following March. We defined the "pre-Covid-19 period" as FY2017-2019, the "Covid-19 period" as FY2020-2022, and "post-Covid-19 period" as FY2023.

RESULTS

A total of 2078 AOM cases were included. The mean age at presentation was 3.5 years. A significant difference in age was present across the three FY time periods. The age during the post-Covid-19 period was significantly higher than that during the pre-Covid-19 period using the pairwise comparisons (p < 0.05). In a multivariate analysis between the pre-Covid-19 and post-Covid-19 periods, age at onset (95 % confidence intervals: 1.02-1.11) was the only independent factor associated with the post-Covid-19 period. Between the Covid-19 and post-Covid-19 periods, age at onset (95 % confidence intervals: 1.02-1.15) and body temperature (95 % confidence intervals: 1.05-1.40) were significantly associated with the post-Covid-19 period.

CONCLUSIONS

A multifactorial effect may have contributed to the increase in age at the onset of AOM during the post-Covid-19 period compared with the other study periods.