The Impact of Prior Covid-19 Infection on Airway Complications in Pediatric Patients Undergoing Tonsillectomy
Poster #: 002
Session/Time: A
Author:
Gabriella Marie Adams, BS
Mentor:
Yifan Guo, MD
Research Type: Descriptive
Abstract
INTRODUCTION:
Tonsillectomy is a common surgical procedure in the U.S. with over 500,000 cases performed annually in children under fifteen. A retrospective study found that perioperative respiratory complications were three times higher in children with airway disease, but was conducted prior to the pandemic (Katz, 2020). This study aims to determine how prior COVID-19 infection impacts the development of respiratory complications in pediatric patients after tonsillectomy.
METHODS:
This study was conducted using the TriNetX research database, utilizing all available data at a national level from all participating healthcare organizations and included all patients undergoing tonsillectomy from January 2020 to January 2024. Patients were grouped into cohorts based on COVID-19 history, excluding those with pre-existing respiratory conditions. The primary outcome included diagnosis of postoperative respiratory complications, identified by ICD-10 codes J95-J96.92, Z99.1, or Z99.11, within 90 days after tonsillectomy.
RESULTS:
After propensity score-matched analysis, each cohort included 53,156 subjects. In the non-COVID-19 cohort, 1,713 subjects experienced respiratory complications compared to 2,323 subjects in the COVID-19 cohort. The risk difference between the two groups was +1.202% (p<0.0001, 95% CI [0.97%, 1.434%]). Kaplan-Meier analysis showed a 1.17% decrease (p<0.0001) in survival probability of those with a prior COVID-19 diagnosis compared to those without at 90 days post-op.
CONCLUSION:
Prior COVID-19 infection was associated with an increased risk of developing respiratory complications, including respiratory failure and pneumothorax, after tonsillectomy. Subjects with a prior COVID-19 diagnosis also had a significantly lower survival probability at 90 days post-op, possibly due to COVID-19 related damage to the respiratory system. While these findings are significant, it is important to consider the limitations of the TriNetX network, such as data inconsistencies and unique coding practices. Nonetheless, these results contribute to a greater understanding of the impact of COVID-19 on postoperative respiratory outcomes and may be useful in guiding preventative strategies.
Tonsillectomy is a common surgical procedure in the U.S. with over 500,000 cases performed annually in children under fifteen. A retrospective study found that perioperative respiratory complications were three times higher in children with airway disease, but was conducted prior to the pandemic (Katz, 2020). This study aims to determine how prior COVID-19 infection impacts the development of respiratory complications in pediatric patients after tonsillectomy.
METHODS:
This study was conducted using the TriNetX research database, utilizing all available data at a national level from all participating healthcare organizations and included all patients undergoing tonsillectomy from January 2020 to January 2024. Patients were grouped into cohorts based on COVID-19 history, excluding those with pre-existing respiratory conditions. The primary outcome included diagnosis of postoperative respiratory complications, identified by ICD-10 codes J95-J96.92, Z99.1, or Z99.11, within 90 days after tonsillectomy.
RESULTS:
After propensity score-matched analysis, each cohort included 53,156 subjects. In the non-COVID-19 cohort, 1,713 subjects experienced respiratory complications compared to 2,323 subjects in the COVID-19 cohort. The risk difference between the two groups was +1.202% (p<0.0001, 95% CI [0.97%, 1.434%]). Kaplan-Meier analysis showed a 1.17% decrease (p<0.0001) in survival probability of those with a prior COVID-19 diagnosis compared to those without at 90 days post-op.
CONCLUSION:
Prior COVID-19 infection was associated with an increased risk of developing respiratory complications, including respiratory failure and pneumothorax, after tonsillectomy. Subjects with a prior COVID-19 diagnosis also had a significantly lower survival probability at 90 days post-op, possibly due to COVID-19 related damage to the respiratory system. While these findings are significant, it is important to consider the limitations of the TriNetX network, such as data inconsistencies and unique coding practices. Nonetheless, these results contribute to a greater understanding of the impact of COVID-19 on postoperative respiratory outcomes and may be useful in guiding preventative strategies.