Tympanostomies and tonsillar surgery in children during the COVID‐19 pandemic in Finland

Abstract

Objective To assess the impact of social restrictions due to COVID‐19 on the number of tympanostomies and tonsillar surgeries in children. Methods Incidences were calculated per 100 000 children for tonsillar surgery and tympanostomies in 2020 and compared to the mean incidence of referral years 2017 to 2019 by incidence rate ratios (IRR) with 95% confidence intervals (CIs). Median waiting times were also compared. Results Before the lockdown, tonsillar surgery incidence was 33.4/100000 (IRR 1.14, CI 0.76‐1.71) in February 2020. After the lockdown began, the incidence of tonsillar surgery was 1.4/100000 (IRR 0.04, CI 0.01‐0.15) in April. In June, tonsillar operation incidence started to increase (20.4 per 100 000). The incidence of tympanostomies was 81% lower (IRR 0.19, CI 0.09‐0.39) in April 2020 and 61% lower (IRR 0.39, CI 0.22‐0.69) in August 2020 than in 2017‐2019. These incidence rates remained lower all year (December 2020 IRR 0.13, CI 0.05‐0.33). Median waiting time for tonsillar surgery was 3.3 months in 2020 and 1.6 months in 2017 to 2019; P <.001, and for tympanostomies 1.3 months in 2020 and 1.0 months in 2017 to 2019, P <.001. The referral rate to otorhinolaryngology during the severest restrictions was 35% lower in April and May 2020 compared with the reference years. Conclusion This study suggests that the restrictions against COVID‐19 reduced the incidence rates of tonsil surgery and tympanostomies in children. Also, the lockdown and cancellations of elective operations in spring 2020 led to increased waiting times. These findings may help in preparing for future pandemics. Level of evidence: Level 3.

Impact of the COVID-pandemic on the incidence of tonsil surgery and sore throat in Germany

“…Gatherings were limited to two persons, and avoiding traveling was recommended. The various measurements resulted not only in a decreased number of COVID-cases but also in a reduction in the number of airway infections in general [20] and particularly in children [21]. This is strongly confirmed by the findings of our study revealing a significantly reduced number doctor contacts with antibiotic prescriptions, particularly in the second quarter (Table 3; Fig.…”

“…However, since there was no compensatory increase in this indication for surgery there must have been a spontaneous resolution taken place. Haapanen et al reported a decrease in the total number of tonsil surgery in 2020 by 37.3% based on rather small pediatric patient population (n = 568 vs. 106.526 of our study) in Finland [21]. The findings compare well to our study (− 34.0%) concerning elective surgery but our update for the first 5 months of the year 2021 revealed a stronger effect (− 54.5%).…”

“…Gatherings were limited to two persons, and avoiding traveling was recommended. The various measurements resulted not only in a decreased number of COVID-cases but also in a reduction in the number of airway infections in general [ 20 ] and particularly in children [ 21 ].…”

Effect of the coronavirus disease 2019 pandemic on paediatric bilateral myringotomy and tube insertion rates in New Brunswick, Canada

“…[15][16][17][18][19] Studies in the USA and Finland have also found lower rates of bilateral myringotomy and tube insertions during the Covid-19 pandemic. 20,21 These findings support our hypothesis that the reduced rate of bilateral myringotomy and tube insertions in New Brunswick during the pandemic was due to decreased URTI transmission.…”

Antibiotic courses for acute otitis media alter human gut microbiome resistome and colonization resistance against antimicrobial resistant species in children

“…Certainly, this study has some limitations. First, our cohort recruitment was badly interrupted due to the COVID-19 world pandemic that reduced our sample size due to a rapid and surprising large reduction of acute otitis media incidence 31,32 . In particular, the azithromycin treatment group was too small.…”