Impact of the COVID-19 pandemic on the incidence of pediatric intracranial empyemas in Spain
- 01-12-2025
- COVID-19
- Research
Published in:
- Authors
- Marina Fidalgo de la Rosa
- Gregorio Catalán Uribarrena
- Pablo Martín Munarriz
- Sara Iglesias Moroño
- Marc Valera Melé
- Juana María Vidal Miñano
- Alicia Godoy Hurtado
- María Elena López García
- Marta Guzmán
- Cristina Ferreras García
- Dalila Forte
- Published in
- Child's Nervous System | Issue 1/2025
Abstract
Introduction
Intracranial infections due to sinusitis and otitis, although rare, can progress rapidly and result in significant morbidity, necessitating multifaceted management including extended antibiotic therapy and surgical intervention. Predominantly affecting infants and older children, these infections have seen a perceived increase in incidence following the coronavirus disease 2019 (COVID-19) pandemic.
Objectives
Our study aims to describe the clinical and epidemiological characteristics of intracranial infections secondary to sinusitis or otitis in the pediatric population and assess changes in incidence and clinical presentation post-pandemic. Specific objectives include analyzing neurosurgical management practices, the role of ENT-neurosurgery cooperation, incidence of epileptic seizures, and management of associated venous thrombosis.
Materials and methods
A retrospective multicentric study was conducted in hospitals across the Iberian Peninsula, including data from January 2018 to December 2022. Data were divided into pre-lockdown (January 2018 to March 2020) and post-lockdown (March 2020 to December 2022) periods for analysis.
Results
The study included 60 pediatric cases (38 post-pandemic and 22 pre-pandemic). The average age was 9.8 years, with a male predominance (61.67%). Sinusitis was the most frequent cause (86%), and the frontal region was the most common site of infection (75%). Neurological symptoms were more prevalent post-pandemic (55.26% versus 23.68%). The primary pathogen was S. intermedius (29.6%). Most patients required neurosurgical intervention (81.7%), with a significant portion undergoing combined ENT–neurosurgery procedures (52.9%). The average antibiotic treatment duration was 6.6 weeks. Complications included venous sinus thrombosis (20%) and seizures (39.2%). Mortality was 3.3%.
Conclusion
Although there was a perceived increase in cases post-pandemic, our study observed a normalization of incidence after the lockdown, with a decrease in diagnoses during confinement. The accepted antibiotic regimen lasts 6 weeks, extendable to 8 weeks in non-surgical patients, with at least 2 weeks of intravenous treatment. Sinus surgery combined with antibiotics may suffice to avoid craniotomy in some cases, while combined surgery has a lower reoperation rate in others. Anticoagulation should be individualized and discontinued upon recanalization. Prophylactic antiepileptic drug use remains controversial and should be tailored to patients with specific risk factors. Prolonged antiepileptic drug (AED) therapy may be warranted for those with early seizures and hemorrhagic lesions, whereas others may gradually taper off AEDs after the acute stage.
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- Title
- Impact of the COVID-19 pandemic on the incidence of pediatric intracranial empyemas in Spain
- Authors
-
Marina Fidalgo de la Rosa
Gregorio Catalán Uribarrena
Pablo Martín Munarriz
Sara Iglesias Moroño
Marc Valera Melé
Juana María Vidal Miñano
Alicia Godoy Hurtado
María Elena López García
Marta Guzmán
Cristina Ferreras García
Dalila Forte
- Publication date
- 01-12-2025
- Publisher
- Springer Berlin Heidelberg
- Keywords
-
COVID-19
Antibiotic
Antiepileptic Drugs
Antiepileptic Drugs
Pediatric Neurosurgery
Craniotomy
Epileptic Seizure - Published in
-
Child's Nervous System / Issue 1/2025
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350 - DOI
- https://doi.org/10.1007/s00381-025-06763-y
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