Temporal Trends in Pediatric Acute Sinusitis Surrounding the COVID-19 Pandemic

Objective. We assessed patterns in the national incidence of pediatric acute sinusitis and associated complications surrounding the initial COVID-19 lockdown.Study Design. Retrospective National Database review.Setting. The Pediatric Health Information System.Methods. Acute sinusitis and associated complication incidence data from 2015 to 2022 were queried. Three time periods of T1, T2, and T3 were defined as: pre-COVID-19 baseline, initial pandemic, and postpandemic. Statistical analysis included Wilcoxon rank sum tests, multivariable logistic regressions, and autoregressive integrated moving averages (ARIMA) to assess differences between the observed complication rates in T2 and T3 and the expected incidence rates in these time periods as estimated from T1 data.Results. We identified 2535 acute sinusitis admissions across 42 centers. The incidence differed between T1 (31.5 cases/month), T2 (15.8 cases/month), and T3 (29 cases/month). Children aged 10 to 14 years had the highest acute sinusitis incidence rate (32.5%) compared to other ages in T2. At T1, acute sinusitis and associated complication rates followed parallel seasonal patterns. Although sinusitis incidence decreased during T2, complications increased significantly during T2 and T3 compared to T1 (37.4% and 39% vs 27.5%, P < .001). In the ARIMA model, the ratio of the observed to expected incidence (95% confidence interval) of complications was 1.09 (0.69, 2.60) in T2 and 1.14 (0.73, 2.62) in T3.Conclusion. We report the simultaneous decrease in acute sinusitis incidence and an increase in associated complications during and after the initial COVID-19 pandemic compared to the prepandemic baseline, reflecting changing patterns in viral infection due to the pandemic.