Acute Mastoiditis in Children During the COVID Era: A Systematic Review and Meta-Analysis

Authors

Erin Briggs, Thomas Jefferson UniversityFollow
Isabelle J. Chau
Shaun A. Nguyen
Justin C. Pelic
Erin A. Harvey
Ted A. Meyer

Document Type

Article

Publication Date

10-22-2025

Comments

This article is the author's final published version in International Journal of Pediatric Otorhinolaryngology, Volume 198, November 2025, Article 112613.

The published version is available at https://doi.org/10.1016/j.ijporl.2025.112613. Copyright © The Author(s).

Abstract

OBJECTIVE: Explore the impact of the COVID-19 pandemic on pediatric acute mastoiditis (AM).

DATA SOURCES: CINAHL, Cochrane Library, PubMed, Scopus.

METHODS: Literature was searched from 2014 to 2025 for articles reporting AM in children. Specific outcomes included clinical presentation, bacterial epidemiology, complications, and management. Primary outcome measures included continuous measures (mean), proportions (%), mean difference (Δ), and relative risk (RR) with 95 % confidence intervals (CI).

RESULTS: There were seven included studies (N = 1001 children) with 632 patients in the pre-COVID cohort and 369 in the COVID-era cohort. There was a significant difference in the proportion of intracranial complications with a 20 % greater risk of having an intracranial complication after the COVID pandemic than before (RR: 1.2 [95 % CI: 0.6-2.3], p = 0.0097). There was also a significant decrease in the proportion of cases treated conservatively with antibiotics after the pandemic (mean difference 10.8 % [95 % CI: 2.9 %-18.0 %], p < 0.01). Bacterial epidemiology also experienced a significant shift in composition following the pandemic.

CONCLUSION: The COVID-19 pandemic has led to a rise in intracranial complications in pediatric AM, with fewer cases being treated solely with antibiotics. Additionally, the pandemic has altered the bacterial epidemiological patterns of AM, highlighting opportunities for further investigation into the characteristics of AM during and after this period to inform and improve future management strategies.

Recommended Citation

Briggs, Erin; Chau, Isabelle J.; Nguyen, Shaun A.; Pelic, Justin C.; Harvey, Erin A.; and Meyer, Ted A., "Acute Mastoiditis in Children During the COVID Era: A Systematic Review and Meta-Analysis" (2025). SKMC Student Presentations and Publications. Paper 78.
https://jdc.jefferson.edu/skmcstudentworks/78

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English