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Yu XS, Tan S, Tang W, Zhao FF, Ji J, Lin J, He HJ, Gu Y, Liang JJ, Wang M, Chen Y, Yang J, Xie L, Wang Q, Liu M, He Y, Chen L, Wang YX, Wu Z, Zhao G, Liu Y, Wang Y, Hao D, Cen J, Yao SQ, Zhang D, Liu L, Lye DC, Hao Z, Wong TY, Cen LP. Multi-dimensional epidemiology and informatics data on COVID-19 wave at the end of zero COVID policy in China. Front Public Health 2024; 12:1442728. [PMID: 39224554 PMCID: PMC11366567 DOI: 10.3389/fpubh.2024.1442728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024] Open
Abstract
Background China exited strict Zero-COVID policy with a surge in Omicron variant infections in December 2022. Given China's pandemic policy and population immunity, employing Baidu Index (BDI) to analyze the evolving disease landscape and estimate the nationwide pneumonia hospitalizations in the post Zero COVID period, validated by hospital data, holds informative potential for future outbreaks. Methods Retrospective observational analyses were conducted at the conclusion of the Zero-COVID policy, integrating internet search data alongside offline records. Methodologies employed were multidimensional, encompassing lagged Spearman correlation analysis, growth rate assessments, independent sample T-tests, Granger causality examinations, and Bayesian structural time series (BSTS) models for comprehensive data scrutiny. Results Various diseases exhibited a notable upsurge in the BDI after the policy change, consistent with the broader trajectory of the COVID-19 pandemic. Robust connections emerged between COVID-19 and diverse health conditions, predominantly impacting the respiratory, circulatory, ophthalmological, and neurological domains. Notably, 34 diseases displayed a relatively high correlation (r > 0.5) with COVID-19. Among these, 12 exhibited a growth rate exceeding 50% post-policy transition, with myocarditis escalating by 1,708% and pneumonia by 1,332%. In these 34 diseases, causal relationships have been confirmed for 23 of them, while 28 garnered validation from hospital-based evidence. Notably, 19 diseases obtained concurrent validation from both Granger causality and hospital-based data. Finally, the BSTS models approximated approximately 4,332,655 inpatients diagnosed with pneumonia nationwide during the 2 months subsequent to the policy relaxation. Conclusion This investigation elucidated substantial associations between COVID-19 and respiratory, circulatory, ophthalmological, and neurological disorders. The outcomes from comprehensive multi-dimensional cross-over studies notably augmented the robustness of our comprehension of COVID-19's disease spectrum, advocating for the prospective utility of internet-derived data. Our research highlights the potential of Internet behavior in predicting pandemic-related syndromes, emphasizing its importance for public health strategies, resource allocation, and preparedness for future outbreaks.
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Affiliation(s)
- Xin-sheng Yu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Shaoying Tan
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Wanting Tang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Fang-fang Zhao
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Jie Ji
- Network & Information Centre, Shantou University, Shantou, China
| | - Jianwei Lin
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Han-jie He
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Youxin Gu
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Jia-Jian Liang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Meng Wang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Yequn Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jiancheng Yang
- Shantou Healthcare Security Administration Center, Shantou, China
| | - Longxu Xie
- Hybribio Medical Laboratory Group Ltd., Chaozhou, China
- Human Papillomavirus Molecular Diagnostic Engineering Technology Research Centre, Chaozhou, China
| | | | - Mengyu Liu
- Shantou University Medical College, Shantou, China
- Hybribio Medical Laboratory Group Ltd., Chaozhou, China
| | - Yang He
- Hybribio Medical Laboratory Group Ltd., Chaozhou, China
| | - Lan Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Ya Xing Wang
- Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhaoxiong Wu
- Jinping District People's Hospital of Shantou, Shantou, China
| | - Gang Zhao
- Zhengzhou Second Hospital, Henan, China
| | - Yi Liu
- Zhengzhou Second Hospital, Henan, China
| | - Yun Wang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | | | - Jingyun Cen
- Shaoguan University Medical College, Shaoguan, China
| | - Shi-Qi Yao
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Dan Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Lifang Liu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - David Chien Lye
- National Centre for Infectious Diseases, Singapore, Singapore
- Tan Tock Seng Hospital, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Zhifeng Hao
- College of Mathematics and Computer Science, Shantou University, Shantou, China
| | - Tien Yin Wong
- Tsinghua Medicine, Tsinghua University, Beijing, China
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
| | - Ling-Ping Cen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
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Rossetti V, Amaddeo A, Vanz D, Boscarelli A, Minute M, Cozzi G. Increase of pyogenic bacterial infections after relaxation of social distancing measures linked to COVID-19 pandemic. Acta Paediatr 2024. [PMID: 39106122 DOI: 10.1111/apa.17381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 07/25/2024] [Accepted: 07/29/2024] [Indexed: 08/09/2024]
Abstract
AIM After the relaxation of COVID-19 mitigation measures, we observed a dramatic increase in pyogenic infections. Based on this observation, we retrospectively analysed all cases of invasive bacterial infections of brain, lung and complicated ear-nose-throat (ENT) infections, in the period from 1 August to 31 March from the years 2018-2019 to 2022-2023. METHODS The study was conducted in two Paediatric Emergency Departments, at IRCCS 'Burlo Garofolo' of Trieste and at Treviso Hospital. Electronic medical records were searched for all cases with a definitive diagnosis at discharge of mastoiditis, suppurative cervical lymphadenitis, retropharyngeal, parapharyngeal and peritonsillar abscess (ENT group), bacterial brain abscesses, epidural empyema, subdural empyema (central nervous system group), thoracic empyema and necrotising pneumonia (lung group). RESULTS In 2022-2023, we observed an increase in infections compared to the previous years. Total number of cases were 22, 29, 8, 27 and 63 in 2018-2019, 2019-2020, 2020-2021, 2021-2022 and 2022-2023, respectively. The greater increase occurred in thoracic empyema, with a peak incidence of +120% in 2022-2023 in respect of 2021-2022. CONCLUSION We reported an important increase in paediatric bacterial complicated infections in two North East Italian regions, possibly correlated with the relaxation of COVID-19 social distancing measures.
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Affiliation(s)
- Vanessa Rossetti
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Daniele Vanz
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | | | - Marta Minute
- Pediatric Unit Ca' Foncello Hospital, Treviso, Italy
| | - Giorgio Cozzi
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
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Jin Y, Yang X, Sun H, Zhang J, Yang S, Jiang S, Song Q, Zhang G, Ma B, Yang K, Pan L, Huang L, Li Y. Global, Regional, and National Burdens of Otitis Media From 1990 to 2019: A Population Based Study. Ear Hear 2024; 45:658-665. [PMID: 38178304 PMCID: PMC11008441 DOI: 10.1097/aud.0000000000001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/05/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES Otitis media is one of the most important causes of hearing loss at an early age. Effective vaccination with the routine 7-valent pneumococcal conjugate vaccine (PCV-7) was introduced in 2000. It has been gradually replaced by the pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine or the higher-valent 13-valent PCV (PCV-13) since 2010. Data on the change in otitis media burden in recent years are sparse at the global, regional, and national levels. DESIGN The Global Burden of Disease 2019 study was used to evaluate the prevalence, incidence, mortality, disability-adjusted life year (DALY) rates, and the average annual percentage changes (AAPCs) in otitis media in geographic populations worldwide from 1990 to 2019. These global trends were further analyzed by subgroup (age, sex, and sociodemographic index [SDI]). RESULTS Globally, the all-age rate of prevalence (AAPC = -0.7, 95% confidence interval [CI] = -0.7 to -0.8), DALYs (AAPC = -1.0, 95% CI = -1.1 to -1.0), and mortality (AAPC = -6.8, 95% CI = -7.3 to -6.4) from otitis media decreased constantly between 1990 and 2019. The all-age rate of incidence decreased sharply between 2000 and 2009 with an AAPC of -1.2 (95% CI = -1.4 to -0.9) and continued the downward trend between 2010 and 2019 (AAPC = -0.2, 95% CI = -0.3 to -0.1). In 2019, children aged 1 to 4 years old had the highest incidence at 29,127.3 per 100,000 population, while young adults under 30 years old accounted for 91.3% of the incident cases. Individuals living in middle-SDI countries had the largest increase in the incidence of otitis media, with an AAPC of 0.3 (95% CI = 0.3 to 0.3) between 1990 and 2019. The incidence and DALYs from otitis media decreased with increasing SDI. Regionally, the largest increase in incidence was observed in high-income Asia Pacific, Eastern Europe, and Western Sub-Saharan Africa between 1990 and 2019. Nationally, the largest increase in the incidence of otitis media was observed in the Republic of Korea, with an AAPC of 0.8 (95% CI = 0.6 to 1.1) in the same time period. CONCLUSIONS There have been successful previous endeavors to reduce DALYs and mortality attributed to otitis media on a global scale. The worldwide incidence of otitis media experienced a sharp decline following the introduction of PCV-7 in 2000, and this downward trend persisted in subsequent years with the adoption of PCV-13/pneumococcal nontypeable Haemophilus influenzae protein D conjugate vaccine. Continual epidemiological surveillance of otitis media's global trends, pathogen distribution, and resistance patterns remains imperative.
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Affiliation(s)
- Yan Jin
- Department of Emergency, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Xue Yang
- Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Hao Sun
- Department of Clinical Epidemiology and Evidence-based Medicine, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Jing Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Health Science Center, Shenzhen University, Shenzhen, China
- These authors contributed equally to this work
| | - Shize Yang
- Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Shuyi Jiang
- Department of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Qingbin Song
- Department of Vascular and Thyroid Surgery, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Guofeng Zhang
- Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Bing Ma
- Department of Clinical Epidemiology and Evidence-based Medicine, The First Hospital of China Medical University, Shenyang, China
- These authors contributed equally to this work
| | - Kaijie Yang
- Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, China
| | - Leilei Pan
- Department of Noncommunicable Chronic Disease Prevention, Liaoning Provincial Center for Disease Prevention and Control, Shenyang, China
| | - Longping Huang
- Department of General Surgery, Hepatobiliary Surgery, The Fourth People’s Hospital of Shenyang, Shenyang, China
| | - Yongze Li
- Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, China
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4
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Qi F, You Z, Guo J, Hong Y, Wu X, Zhang D, Li Q, Cai C. An automatic diagnosis model of otitis media with high accuracy rate using transfer learning. Front Mol Biosci 2024; 10:1250596. [PMID: 38577506 PMCID: PMC10991843 DOI: 10.3389/fmolb.2023.1250596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/27/2023] [Indexed: 04/06/2024] Open
Abstract
Introduction: Chronic Suppurative Otitis Media (CSOM) and Middle Ear Cholesteatoma are two common chronic otitis media diseases that often cause confusion among physicians due to their similar location and shape in clinical CT images of the internal auditory canal. In this study, we utilized the transfer learning method combined with CT scans of the internal auditory canal to achieve accurate lesion segmentation and automatic diagnosis for patients with CSOM and middle ear cholesteatoma. Methods: We collected 1019 CT scan images and utilized the nnUnet skeleton model along with coarse grained focal segmentation labeling to pre-train on the above CT images for focal segmentation. We then fine-tuned the pre-training model for the downstream three-classification diagnosis task. Results: Our proposed algorithm model achieved a classification accuracy of 92.33% for CSOM and middle ear cholesteatoma, which is approximately 5% higher than the benchmark model. Moreover, our upstream segmentation task training resulted in a mean Intersection of Union (mIoU) of 0.569. Discussion: Our results demonstrate that using coarse-grained contour boundary labeling can significantly enhance the accuracy of downstream classification tasks. The combination of deep learning and automatic diagnosis of CSOM and internal auditory canal CT images of middle ear cholesteatoma exhibits high sensitivity and specificity.
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Affiliation(s)
- Fangyu Qi
- Department of Anesthesiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | - Zhiyu You
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | - Jiayang Guo
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | - Yongjun Hong
- Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Xiaolong Wu
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | | | - Qiyuan Li
- School of Medicine, Xiamen University, Xiamen, China
- National Institute for Data Science in Health and Medicine, Xiamen University, Xiamen, China
| | - Chengfu Cai
- College of Otorhinolaryngology Head and Neck Surgery, Xiamen Haicang Hospital, Xiamen, China
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5
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Müskens JLJM, Olde Hartman TC, Schers HJ, Akkermans RP, Westert GP, Kool RB, van Dulmen SA. Trends in low-value GP care during the COVID-19 pandemic: a retrospective cohort study. BMC PRIMARY CARE 2024; 25:73. [PMID: 38418951 PMCID: PMC10900726 DOI: 10.1186/s12875-024-02306-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Several studies showed that during the pandemic patients have refrained from visiting their general practitioner (GP). This resulted in medical care being delayed, postponed or completely forgone. The provision of low-value care, i.e. care which offers no net benefit for the patient, also could have been affected. We therefore assessed the impact of the COVID-19 restrictions on three types of low-value GP care: 1) imaging for back or knee problems, 2) antibiotics for otitis media acuta (OMA), and 3) repeated opioid prescriptions, without a prior GP visit. METHODS We performed a retrospective cohort study using registration data from GPs part of an academic GP network over the period 2017-2022. The COVID-19 period was defined as the period between April 2020 to December 2021. The periods before (January 2017 to April 2020) and after the COVID-19 period (January 2022 to December 2022) are the pre- and post-restrictions periods. The three clinical practices examined were selected by two practicing GPs from a top 30 of recommendations originating from the Dutch GP guidelines, based on their perceived prevalence and relevance in practice (van Dulmen et al., BMC Primary Care 23:141, 2022). Multilevel Poisson regression models were built to examine changes in the incidence rates (IR) of both registered episodes and episodes receiving low-value treatment. RESULTS During the COVID-19 restrictions period, the IRs of episodes of all three types of GP care decreased significantly. The IR of episodes of back or knee pain decreased by 12%, OMA episodes by 54% and opioid prescription rate by 13%. Only the IR of OMA episodes remained significantly lower (22%) during the post-restrictions period. The provision of low-value care also changed. The IR of imaging for back or knee pain and low-value prescription of antibiotics for OMA both decreased significantly during the COVID-restrictions period (by 21% and 78%), but only the low-value prescription rate of antibiotics for OMA remained significantly lower (by 63%) during the post-restrictions period. The IR of inappropriately repeated opioid prescriptions remained unchanged over all three periods. CONCLUSIONS This study shows that both the rate of episodes as well as the rate at which low-value care was provided have generally been affected by the COVID-19 restrictions. Furthermore, it shows that the magnitude of the impact of the restrictions varies depending on the type of low-value care. This indicates that deimplementation of low-value care requires tailored (multiple) interventions and may not be achieved through a single disruption or intervention alone.
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Affiliation(s)
- Joris L J M Müskens
- Radboud University Medical Center, IQ Health Science Department, Nijmegen, The Netherlands.
| | - Tim C Olde Hartman
- Radboud University Medical Center, Department of Primary and Community Care at Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Henk J Schers
- Radboud University Medical Center, Department of Primary and Community Care at Radboud Institute for Health Sciences, Nijmegen, the Netherlands
| | - Reinier P Akkermans
- Radboud University Medical Center, IQ Health Science Department, Nijmegen, The Netherlands
| | - Gert P Westert
- Radboud University Medical Center, IQ Health Science Department, Nijmegen, The Netherlands
| | - Rudolf B Kool
- Radboud University Medical Center, IQ Health Science Department, Nijmegen, The Netherlands
| | - Simone A van Dulmen
- Radboud University Medical Center, IQ Health Science Department, Nijmegen, The Netherlands
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6
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Pershad AR, Knox EC, Shah RK, Zalzal HG. Disparities in the prevalence and management of otitis media: A systematic review. Int J Pediatr Otorhinolaryngol 2024; 176:111786. [PMID: 37984128 DOI: 10.1016/j.ijporl.2023.111786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Alisha R Pershad
- School of Medicine and Health Sciences, The George Washington University, Washington, D.C, USA.
| | - Emily C Knox
- School of Medicine and Health Sciences, The George Washington University, Washington, D.C, USA
| | - Rahul K Shah
- Division of Otolaryngology-Head and Neck Surgery, Children's National Medical Center, Washington, D.C, USA
| | - Habib G Zalzal
- Division of Otolaryngology-Head and Neck Surgery, Children's National Medical Center, Washington, D.C, USA
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Pelton SI, Hullegie S, Leach AJ, Marchisio P, Marom T, Sabharwal V, Shaikh N, Tähtinen PA, Venekamp RP. ISOM 2023 Research Panel 5: Interventions- Vaccines and prevention, medical and surgical treatment, and impact of COVID-19 pandemic. Int J Pediatr Otorhinolaryngol 2024; 176:111782. [PMID: 38000342 PMCID: PMC10842145 DOI: 10.1016/j.ijporl.2023.111782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/05/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023]
Abstract
OBJECTIVES To identify and synthesize key research advances from the literature published between 2019 and 2023 on the advances in preventative measures, and medical and surgical treatment of uncomplicated otitis media (OM) including the impact of the COVID-19 pandemic on OM management. DATA SOURCES Medline (PubMed), Embase, and the Cochrane Library. REVIEW METHODS All relevant original articles published in English between June 2019 and February 2023 were identified. Studies related to guideline adherence, impact of treatment on immune response and/or microbiology, tympanoplasty, Eustachian tube balloon dilatation, mastoidectomy procedures, and those focusing on children with Down's syndrome or cleft palate were excluded. MAIN FINDINGS Of the 9280 unique records screened, 64 were eligible for inclusion; 23 studies related to medical treatment, 20 to vaccines, 13 to surgical treatment, 6 to prevention (excl. vaccines) and 2 to the impact of COVID-19 on OM management. The level of evidence was judged 2 in 11 studies (17.2 %) and 3 or 4 in the remaining 53 studies (82.8 %) mainly due to the observational design, study limitations or low sample sizes. Some important advances in OM management have been made in recent years. Video discharge instructions detailing the identification and management of pain and fever for parents of children with acute otitis media (AOM) was more effective than paper instructions in reducing symptomatology; compared to placebo, levofloxacin solution was more effective for treating chronic suppurative otitis media, whereas AOM recurrences during two years of follow-up did not differ between children with recurrent AOM who received tympanostomy tube (TT) insertion or medical management. Further, novel pneumococcal conjugate vaccines (PCV) schedules for preventing OM in Aboriginal children appeared ineffective, and a protein-based pneumococcal vaccine had no added value over PCV13 for preventing AOM in native American infants. During the COVID-19 pandemic, a decline in OM and TT case volumes and complications was observed. IMPLICATION FOR PRACTICE AND FUTURE RESEARCH Whether the observed impact of the COVID-19 pandemic on OM management extends to the post-pandemic era is uncertain. Furthermore, the impact of the pandemic on the conduct of urgently needed prospective methodologically rigorous interventional studies aimed at improving OM prevention and treatment remains to be elucidated since the current report consisted of studies predominantly conducted in the pre-pandemic era.
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Affiliation(s)
- Stephen I Pelton
- Department of Pediatrics, Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA.
| | - Saskia Hullegie
- Julius Center for Health Sciences and Primary Care, Department of General Practice and Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
| | - Amanda J Leach
- Child Health Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Paola Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; University of Milan, Milan, Italy
| | - Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ashdod, Israel and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er-Sheva, Israel
| | - Vishakha Sabharwal
- Department of Pediatrics, Section of Infectious Diseases, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA
| | - Nader Shaikh
- Division of General Academic Pediatrics, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Paula A Tähtinen
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Roderick P Venekamp
- Julius Center for Health Sciences and Primary Care, Department of General Practice and Nursing Science, University Medical Center Utrecht, University Utrecht, Utrecht, the Netherlands
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8
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Lev Ari O, Hazan I, Moran-Gilad J, Kerman T, Tsumi E. The impact of the COVID-19 pandemic on pediatric acute conjunctivitis disease trends. Sci Rep 2023; 13:20132. [PMID: 37978225 PMCID: PMC10656534 DOI: 10.1038/s41598-023-47382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023] Open
Abstract
The COVID-19 pandemic notably influenced the transmission of infectious diseases across various age groups. In this study, we assessed its impact on pediatric acute conjunctivitis trends in southern Israel. We analyzed acute conjunctivitis diagnoses from 2017 to 2022, categorizing them into pre-lockdown, lockdown, and post-lockdown intervals. A control group of non-infectious dermatologic conditions was included. Time-series analysis, adjusted for seasonality, was employed. Pre-lockdown data indicated steady conjunctivitis diagnoses, primarily in winter. Post-lockdown interval exhibited an added summer peak before the regular winter surge. The lockdown saw a 56% decline in diagnoses, most pronounced in younger ages. Post-lockdown observed a 7% overall drop with age-specific variations. The acute conjunctivitis IRR was 0.44 (95% CI 0.39-0.49) during lockdowns and 0.93 (95% CI 0.86-1.02) post-lockdowns. Control group IRRs were 0.84 (95% CI 0.78-0.89) and 0.90 (95% CI 0.84-0.96), respectively, with the 0-5 age range demonstrating significant disparities. Pediatric acute conjunctivitis in southern Israel decreased significantly during the pandemic. Post-lockdown patterns varied by age group. An unusual summer peak in cases was observed post-lockdown; this peak may be influenced by a combination of altered behaviors in the summer and possibly increased susceptibility to infection.
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Affiliation(s)
- Omer Lev Ari
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Itai Hazan
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Jacob Moran-Gilad
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Tomer Kerman
- Clinical Research Center, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Joyce and Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Erez Tsumi
- Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Sheikh A, Capello C, AlMubarak Z, Dzioba A, You P, Nashid N, Barton M, Husein M, Strychowsky JE, Graham ME. Changes in operative otolaryngology infections related to the COVID19 pandemic: A retrospective cohort study. Int J Pediatr Otorhinolaryngol 2023; 171:111650. [PMID: 37437498 DOI: 10.1016/j.ijporl.2023.111650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Pediatric emergency admissions fell significantly during the COVID-19 pandemic. This study investigated the changes in severe infectious complications managed by otolaryngology between the pre-pandemic period and the first year of the pandemic to determine if COVID-19 or related public health measures influenced the rate or severity of presentations managed in otolaryngology. METHODS A retrospective chart review was conducted on pediatric patients who presented with severe infectious otolaryngology presentations (acute mastoiditis, deep neck space abscesses, and orbital complications of sinusitis) over the pre-pandemic (March 2018-February 2020) and early pandemic (March 2020-February 2021) periods. Patient characteristics, details of presentation, treatment, and outcomes were extracted from patients' charts. Independent samples t-tests/Mann-Whitney U-tests for continuous variables and Pearson chi-squared tests/Fisher's exact test for categorical variables were conducted to compare the pre vs early pandemic groups. RESULTS There were 93 pre-pandemic and 28 early pandemic presentations. The monthly case average was significantly lower during the early pandemic period than the 2 years prior [3.58 (2.80) vs 2.00 (2.00), P = .045]. The average monthly frequency of presentations for deep neck space abscess and mastoiditis were significantly higher in the pre-pandemic group when compared to the early pandemic group [1.96 (±0.33) vs 1.33 (±0.48), P = .049; .71 (±0.26) vs 0.17 (±0.41), P = .01, respectively]. The early pandemic group was significantly younger (3.81 vs 6.04 years, P = .005), however there were no differences in gender, length of admission, and days from symptom onset to presentation between the two groups (P > .05). The early pandemic group had significantly elevated inflammatory markers on presentation [CRP, WBC, neutrophils (P = .02, P = .02, P = .04, respectively)] compared to the pre-pandemic group. CONCLUSION The COVID-19 pandemic has had an effect on severe infectious complications of ENT pathologies, including decreased average monthly cases during the early pandemic, younger age at presentation, and elevated inflammatory markers.
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Affiliation(s)
- Adeel Sheikh
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada
| | - Chris Capello
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada
| | - Zaid AlMubarak
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Agnieszka Dzioba
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Peng You
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Nancy Nashid
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Division of Infectious Disease, Department of Pediatrics, London Health Sciences Centre, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Michelle Barton
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Division of Infectious Disease, Department of Pediatrics, London Health Sciences Centre, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Murad Husein
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - Julie E Strychowsky
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada
| | - M Elise Graham
- Schulich School of Medicine and Dentistry, Western University, 1151 Richmond St, London, ON, N6A 5C1, Canada; Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre, Box 5010, 800 Commissioners Road E, London, ON, N6A 5W9, Canada.
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