Social Segregation Cut Down the Prevalence of Acute Otitis Media in Children : Time-series Analyses From Non-pandemic and COVID-19 Period

Abstract Background: Preventing or reducing the attacks of acute otitis media (AOM) is a major worldwide healthcare problem in children. It is therefore urgent to evaluate the additional, unintended benefits of social segregation in cutting down the prevalence of AOM in children of various ages, especially during coronavirus disease 2019 (COVID-19) periods.Methods: Children aged from 6 months to 12 years who suffer from AOM and attended the outpatient clinic of tertiary hospital in the Eye Ear Nose Throat Hospital Affiliated to Fudan University in Shanghai were investigated from January 2015 to December 2020. The change in daily outpatient attendance for AOM and time-series analyses were estimated following both non-pandemic and COVID-19 period, and age and gender were taken into account. Results: 24543 outpatients (male:13529, female:11014) were enrolled in this clinic population. The epidemic trend of AOM in 2015-2019 was characterized by seasonal fluctuations, with a higher incidence in December and January but relatively lower outpatient records in winter and summer vacations (February, June and August). There was an estimated 63.6% (54.32%-70.36%) reduction in the daily outpatient attendance of AOM associated with the introduction of social segregation in COVID-19 period. When age was taken into account, children aged 4-6 who are in kindergarten were more vulnerable to AOM (66.2%), especially during the school period. Meanwhile, the outpatient attendance of AOM in preschoolers (before the age of three) was mainly in autumn and winter, with no significant relationship with semester change. And age structure of AOM in COVID-19 period broadly in line with that in non-pandemic period. Conclusions: Data from non-pandemic and COVID-19 periods indicated that AOM might spread into susceptible populations by close contact, and social segregation could effectively reduce the likelihood of catching AOM. In tandem with broader consequences, certain interpersonal distance, mask effects and good hand hygiene can significantly reduce the incidence of AOM, which provides a preventive and therapeutic point of view for AOM.