(For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.) It is observed that there are LY450108 no increased incidences in the total of ENT infections, regardless of their severity. they had overcome the COVID- LY450108 19. Results 620 patients from 1022 Rabbit Polyclonal to Thyroid Hormone Receptor beta were eligible for the study. We observed a significant outbreak in the incidence of complicated mastoiditis and deep cervical infections LY450108 with complications in the year 2020 (13 patients) linked to the COVID-19 pandemic. From these patients, 54% had been confirmed or had high suspicion of close contact with COVID-19.15.4% of children were positive in serological tests for IgG antibodies. Conclusion There has been a significant increase in mastoiditis and deep cervical infections with complications in the first four months of 2020, which constitutes an outbreak. A considerable number (54%) of these complicated infections were related to close contact with COVID-19. Still, only 15.4% were positive in serological tests for IgG antibodies, so we cannot establish a direct categorical relationship. The limitations in primary care due to a shortage of human resources in dealing with the pandemic’s initial onslaught and changes in help-seeking behavior could explain increased complicated infections. We consider mastoiditis with complications if intracranial or extracranial, such as intracranial abscess, jugular thrombosis, venous sinus thrombosis, subperiosteal abscess, facial paralysis, or labyrinthitis. Complicated sinusitis was assumed if an intracranial abscess or orbital complications such as intraorbital abscess, subperiosteal abscess, pre or post septal orbital cellulitis. Besides, we include retropharyngeal, parapharyngeal, submandibular, parotid, and multi-space abscesses as deep cervical infections. Peritonsillar abscess, adenophlegmon or cervical lymphadenitis without abscess, abnormalities of the branchial cleft, and infections due to embryonic development abnormalities were excluded from this group. Likewise, a stratified analysis was carried out according to whether the infection was complicated and if the patients had been referred from another hospital. Endemic channels graphically show the current incidence against the historical incidence to detect abnormally high disease cases [7]. Hence, we designed endemic channels to analyze the incidence presented in the year 2020 regarding what was expected based on historical data from 2010 to 2019. The methodology for elaborating the endemic channels was through quartiles and monthly cumulative incidence, which is recommended as there is a low annual incidence of cases [7]. In the endemic channels, four areas were designed, determined by the quartiles of the cases observed in the previous years from 2010 to 2019: success (green area), security (yellow area), alarm (red area), and outbreak. Similarly, a dispersion analysis of the number of new patients presented in the first four months of each year from 2010 to 2020 was carried out, calculating the median and standard deviation. Likewise, a comparative analysis of the mean number of patients with complicated infections per month in the first four months of 2020 was carried out for previous years using the non-parametric Mann-Whitney test. A telephone interview was then conducted with all the parents of the children who presented a severe ENT infection in the year 2020 to determine whether they had epidemiological contact with COVID-19 and its statistical significance. Finally, a serological test for IgG antibodies was carried out on all the children to know if they had overcome COVID-19. The statistical significance level was p? ?0.05, and statistical analysis was carried out through Microsoft Excel v. 16.31 and SPSS Statistic v. 22. 3.?Results We reviewed 1022 clinical histories; 376 were not included due to insufficient data or because they were not within the period of interest studied. Sixteen patients were excluded due to infections originating from embryonic development abnormalities, and ten patients were excluded due to coding errors. Thus, the analysis was carried out on 620 patients eligible for the study. Table 1 describes the number of patients with pediatric infections by location and is stratified for the presence of complications and whether or not they have been referred from another hospital. Table 1 Number of patients analyzed classified by infection location, complications, and if the patients had been referred from another hospital. thead th rowspan=”2″ colspan=”1″ Number of patients /th th colspan=”2″ rowspan=”1″ Total patients hr / /th th colspan=”2″ rowspan=”1″ Infections with complications hr / /th th rowspan=”1″ colspan=”1″ Total /th th rowspan=”1″ colspan=”1″ No referrals from other hospitals /th th rowspan=”1″ colspan=”1″ Total /th th rowspan=”1″.