Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications

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Abstract

Objective

To evaluate the role of social isolation during the lockdown due to the SARS-CoV-2 outbreak (severe acute respiratory syndrome coronavirus 2) in modifying the prevalence of otitis media with effusion (OME) and the natural history of chronic OME.

Study Design

Retrospective study.

Setting

Tertiary level referral audiologic center.

Methods

We assessed the prevalence of OME among children aged 6 months to 12 years who attended the outpatient clinic for hearing or vestibular disorders during 2 periods before the lockdown, May-June 2019 (n = 350) and January-February 2020 (n = 366), and the period immediately after the lockdown, May-June 2020 (n = 216). We also compared the disease resolution rates between a subgroup of children with chronic OME (n = 30) who were diagnosed in summer 2019 and reevaluated in May-June 2020 and a similar subgroup (n = 29) assessed in 2018-2019.

Results

The prevalence of OME in this clinic population was 40.6% in May-June 2019, 52.2% in January-February 2020, and 2.3% in May-June 2020. Children with chronic OME had a higher rate of disease resolution in May-June 2020 (93.3%) than those examined in May-June 2019 (20.7%, P < .001).

Conclusion

Closure of schools and the physical distancing rules were correlated with a reduction in the prevalence of OME and favored the resolution of its chronic forms among children who attended the outpatient clinic. These data could suggest that in the presence of chronic OME, keeping young children out of group care settings for a period might be beneficial to allow for OME resolution.

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The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China

Hien Lau, Veria Khosrawipour, Piotr Paweł Kocbach … (2020)

Abstract Background With its epicenter in Wuhan, China, the COVID-19 outbreak was declared a public health emergency of international concern (PHEIC) by the World Health Organization (WHO). Consequently, many countries have implemented flight restrictions to China. China itself has imposed a lockdown of the population of Wuhan as well as the entire Hubei province. However, whether these two enormous measures have led to significant changes in the spread of COVID-19 cases remains unclear. Methods We analyzed available data on the development of confirmed domestic and international COVID-19 cases before and after lockdown measures. We evaluated the correlation of domestic air traffic to the number of confirmed COVID-19 cases and determined the growth curves of COVID-19 cases within China before and after lockdown as well as after changes in COVID-19 diagnostic criteria. Results Our findings indicate a significant increase in doubling time from 2 days (95% Confidence Interval, CI): 1.9–2.6), to 4 days (95% CI: 3.5–4.3), after imposing lockdown. A further increase is detected after changing diagnostic and testing methodology to 19.3 (95% CI: 15.1–26.3), respectively. Moreover, the correlation between domestic air traffic and COVID-19 spread became weaker following lockdown (before lockdown: r = 0.98, p < 0.05 vs. after lockdown: r = 0.91, p = NS). Conclusions A significantly decreased growth rate and increased doubling time of cases was observed, which is most likely due to Chinese lockdown measures. A more stringent confinement of people in high risk areas seem to have a potential to slow down the spread of COVID-19.

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Otitis media

Anne G. M. Schilder, Tasnee Chonmaitree, Allan W Cripps … (2016)

Otitis media (OM) or middle ear inflammation is a spectrum of diseases, including acute otitis media (AOM), otitis media with effusion (OME; ‘glue ear’) and chronic suppurative otitis media (CSOM). OM is among the most common diseases in young children worldwide. Although OM may resolve spontaneously without complications, it can be associated with hearing loss and life-long sequelae. In developing countries, CSOM is a leading cause of hearing loss. OM can be of bacterial or viral origin; during ‘colds’, viruses can ascend through the Eustachian tube to the middle ear and pave the way for bacterial otopathogens that reside in the nasopharynx. Diagnosis depends on typical signs and symptoms, such as acute ear pain and bulging of the tympanic membrane (eardrum) for AOM and hearing loss for OME; diagnostic modalities include (pneumatic) otoscopy, tympanometry and audiometry. Symptomatic management of ear pain and fever is the mainstay of AOM treatment, reserving antibiotics for children with severe, persistent or recurrent infections. Management of OME largely consists of watchful waiting, with ventilation (tympanostomy) tubes primarily for children with chronic effusions and hearing loss, developmental delays or learning difficulties. The role of hearing aids to alleviate symptoms of hearing loss in the management of OME needs further study. Insertion of ventilation tubes and adenoidectomy are common operations for recurrent AOM to prevent recurrences, but their effectiveness is still debated. Despite reports of a decline in the incidence of OM over the past decade, attributed to the implementation of clinical guidelines that promote accurate diagnosis and judicious use of antibiotics and to pneumococcal conjugate vaccination, OM continues to be a leading cause for medical consultation, antibiotic prescription and surgery in high-income countries. Supplementary information The online version of this article (doi:10.1038/nrdp.2016.63) contains supplementary material, which is available to authorized users.

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Sex Differences in Pediatric Infectious Diseases

Maximilian Muenchhoff, Philip Goulder (2014)

The success of the immune response is finely balanced between, on the one hand, the need to engage vigorously with, and clear, certain pathogens; and, on the other, the requirement to minimize immunopathology and autoimmunity. Distinct immune strategies to achieve this balance have evolved in females and males and also in infancy through to adulthood. Sex differences in outcome from a range of infectious diseases can be identified from as early as fetal life, such as in congenital cytomegalovirus infection. The impact of sex hormones on the T-helper 1/T-helper 2 cytokine balance has been proposed to explain the higher severity of most infectious diseases in males. In the minority where greater morbidity and mortality is observed in females, this is hypothesized to arise because of greater immunopathology and/or autoimmunity. However, a number of unexplained exceptions to this rule are described. Studies that have actually measured the sex differences in children in the immune responses to infectious diseases and that would further test these hypotheses, are relatively scarce.

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Author and article information

Journal

Journal ID (nlm-ta): Otolaryngol Head Neck Surg

Journal ID (iso-abbrev): Otolaryngol Head Neck Surg

Journal ID (publisher-id): OTO

Journal ID (hwp): spoto

Title: Otolaryngology--Head and Neck Surgery

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 0194-5998

ISSN (Electronic): 1097-6817

Publication date (Electronic): 26 January 2021

Electronic Location Identifier: 0194599820987458

Affiliations

[1 ]Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

[2 ]Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

[3 ]Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

[4 ]Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

[5 ]Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Ital

[6 ]Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

Author notes

[*]Mirko Aldè, MD, Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122 Milan, Italy. Email: mirko.alde@ 123456unimi.it

Article

Publisher ID: 10.1177_0194599820987458

DOI: 10.1177/0194599820987458

PMC ID: 7841252

PubMed ID: 33494659

SO-VID: 59a5f289-65ef-47f8-a02e-be6a849bc3c4

License:

This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 2 October 2020

Date accepted : 21 December 2020

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ScienceOpen disciplines: Surgery

Keywords: otitis media with effusion,children,covid-19,lockdown,physical distancing,day care attendance

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ScienceOpen disciplines: Surgery

Keywords: otitis media with effusion, children, covid-19, lockdown, physical distancing, day care attendance

Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications

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Abstract

Objective

Study Design

Setting

Methods

Results

Conclusion

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Novel Coronavirus Disease COVID-19

Most cited references 29

The positive impact of lockdown in Wuhan on containing the COVID-19 outbreak in China

Otitis media

Sex Differences in Pediatric Infectious Diseases

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