Children with previous COVID-19 infection are more likely to present with recurrent acute otitis media or tube otorrhea

Objective

Since December 2021, the number of children with COVID-19 infections has increased. Sequelae in children have not been well-described. Our goal was to determine if children with a history of COVID-19 infection (C19 group) were more likely to present with recurrent acute otitis media (rAOM) or post-ventilation tube otorrhea (VTO) than children who had no history of COVID-19 infection (NoC19 group).

Methods

Charts of consecutive children presenting at a pediatric otolaryngology clinic from March–May 2022 were reviewed. Demographics, COVID-19 test history, comorbidities, ultimate diagnosis, physical exam findings, and management plan were included. No children had a known COVID-19 infection at the time of visit.

Results

524 children were included, 228 (43.5 %) girls and 296 (56.5 %) boys. Mean age was 5 years (95 % CI 4.6–5.4). 115 (21.9 %) had a history of COVID-19 infection.

104 (19.8 %) had a diagnosis of rAOM or VTO, 26.1 % (30/115) children in C19 and 18.1 % (74/409) children in NoC19 (Fisher's Exact p = .04, OR = 1.6). For children without ventilation tubes in place, 23.5 % (27/115) in C19 had rAOM versus 15.2 % (62/409) in NoC19 (p = .03, OR = 1.7). 18.3 % (21/115) of the C19 group had nasal congestion compared to 6.6 % (27/409) of the NoC19 group (p < .001, OR = 3.2). There was no difference in incidence of otitis media with effusion, tonsil/adenoid hypertrophy, sleep-disordered breathing, or epistaxis between the groups.

Conclusion

Infection with COVID-19 may be associated with an increased risk of rAOM and VTO in children. This may affect healthcare utilization by increasing the need for pediatric and otolaryngologic care.