Increased Incidence of Intracranial Abscesses in Pediatric Patients Following the COVID-19 Pandemic: A National Retrospective Cohort Analysis

Introduction: Recent studies have indicated that rates of intracranial abscesses in pediatric patients have increased since the start of the COVID-19 pandemic. While the mechanism is not yet fully understood, it has been hypothesized that SARS-CoV-2 may increase susceptibility to opportunistic infections, thereby leading to increased rates of intracranial infections. To investigate this, we examined the association between COVID-19 infection and the incidence of intracranial abscesses in pediatric patients using a national database.

Methods: The TriNetX online health record database was queried for patients 18 years of age or younger who presented for any healthcare visit, either with or without a positive test result for COVID-19, any time after March 2020. Propensity score matching yielded 2,302,150 patients for comparison. The outcomes analyzed were any new intracranial abscess and any new cerebral cyst that occurred within 180 days of the positive test result for the COVID-19 cohort or the date of the visit for the control cohort.

Results: Pediatric patients with a positive test result for COVID-19 showed a significantly higher rate of intracranial abscess, granuloma, or unspecified extradural or subdural abscess (p < 0.0001), along with a significantly higher rate of cerebral cysts (p < 0.0001) when compared to patients who never tested positive for COVID-19.

Conclusion : The results of our analysis indicate that COVID-19 infection in pediatric patients is associated with increased rates of intracranial abscesses. This lends further support to the hypothesis that SARS-CoV-2 plays a role in increasing susceptibility to subsequent intracranial infection, although further investigation is necessary to determine the exact relationship between COVID-19 and intracranial abscess development in pediatric patients.