Odontogenic Infections are More Frequent and More Severe during COVID-19 Pandemic

The COVID-19 pandemic has created a global decrease in access to routine healthcare. This public health crisis has led to limited access to healthcare during the COIVD-19 pandemic due to public perception of quarantine regulations, loss of jobs and health insurance, and fear of contracting the virus from visiting healthcare providers (Anderson et al, 2021). Thus, a delay in treatment occurs for a multitude of medical and dental problems, leading to a challenge to the medical community due to emergent situations. This includes an increase in the number of people developing more severe deep space infections of the head and neck. A 2018 systematic review found that of all deep neck space infections, there was a 36% incidence of a dental-related source (Pardal-Pelaez et al, 2018), placing the burden of management often on those in the oral and maxillofacial community. When a patient with these severe infections needs treatment, they utilize the already-strained resources of the hospital, including operating room time and ICU beds. Although several vaccines are now available to some populations, epidemiologists agree there is a long way from the end of the acute impact of COVID-19 on the healthcare system. The authors' service had perceived an increase of admissions for severe head and neck infections over the past year since the pandemic began. This retrospective study reviews the admissions and treatment of severe head and neck infections during the time period of January 2020 to January 2021 compared to the past 2 years to verify this increase and examine the specific causes of this potentially life-threatening problem. Data were gathered via general chart review of patient admitted for deep space infections from January 2018 to January 2021 at Emory University and Grady Memorial in Atlanta, GA. The surgical patient population was identified through the use of ICP and CPT codes. This study looks at variables including demographics and medical comorbidities, severity of infection, COVID-19 status, cultures, length of stay, and necessity for ICU care, as well as outcomes and complications and need for reoperation. Early analysis of this preliminary data shows an 8% increase in deep neck space infections treated from 2018 to 2019, and a 19.8% increase from 2019 to 2020. This clear upward trend of admissions for deep neck space infections over the past year indicate more needs to be done to try to keep patients out of the hospital and safe.