Suppurative Cervical Infections in Australian Children: A Retrospective Cohort Study Pre- and Post-COVID-19 Pandemic.

Background: Pediatric cervical infections, including cervical lymphadenitis and deep neck space infections, are potentially life-threatening. Nonpharmaceutical interventions (NPIs) implemented to control the COVID-19 pandemic have altered the epidemiology of many infectious diseases in children. This study aimed to assess the impact of NPIs directed against COVID-19 on the epidemiology of cervical infections in an Australian pediatric population.

Methodology: A retrospective cohort study was conducted at the 2 largest pediatric tertiary hospitals in Sydney, New South Wales, Australia. Children (0-16 years inclusive) with a suppurative cervical infection presenting between July 1, 2017 to June 30, 2019 (prepandemic cohort) and July 1, 2021 to June 30, 2023 (postpandemic cohort) were included. Detailed clinical and demographic data were extracted. Descriptive analyses, including statistical tests of comparison, were performed to compare the pre- and postpandemic cohorts.

Results: Three hundred twenty-nine patients with cervical infections were included: 150 in the prepandemic cohort and 179 in the postpandemic cohort. There was a significant increase in the number of retropharyngeal/parapharyngeal infections in the postpandemic cohort. Additionally, infections were more severe, with patients presenting earlier to hospital with larger abscesses. Management was also more aggressive, with greater administration of corticosteroids and longer hospital stays. These changes post-COVID-19 were most pronounced in infections caused by Streptococcus pyogenes.

Conclusion: The relaxation of NPIs directed against COVID-19 appears to correlate with an increased incidence and severity of suppurative cervical infections in Australian. This concurs with the changing epidemiology of infectious diseases in pediatric populations following the pandemic, both within Australia and globally.