Risk of post-tonsillectomy hemorrhage among COVID-19 positive pediatric patients

Int J Pediatr Otorhinolaryngol. 2024 Apr:179:111890. doi: 10.1016/j.ijporl.2024.111890. Epub 2024 Feb 8.

Abstract

Objective: COVID-19 infection has been demonstrated to increase risk for post-operative bleeding. This study investigated the impact of COVID-19 infection on post-tonsillectomy hemorrhage in pediatric patients, a potentially devastating complication.

Study design: Retrospective cohort study.

Methods: The TriNetX database was queried for pediatric patients who underwent tonsillectomy and evaluated for outcomes of primary and secondary post-tonsillectomy hemorrhage.

Results: Among subjects 18 years and younger, 1226 were COVID-19 positive and 38,241 were COVID-19 negative in the perioperative period. There was statistically significant increased risk of bleeding with perioperative COVID-19 infection at postoperative days 1, 5, and 10. Additionally, when assessing the role of COVID-19 infection before or after surgery, the risk of bleeding remained statistically significant at all three time points, however these results did not suggest that infection before surgery confers more/less risk compared to infection after.

Conclusion: The results of this investigation suggest that the presence of COVID-19 in the perioperative period may pose an increased risk for acute or delayed post tonsillectomy hemorrhage. This study employed a large, diverse population and is the first to address this clinical question.

MeSH terms

  • COVID-19* / complications
  • Child
  • Humans
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology
  • Postoperative Period
  • Retrospective Studies
  • Tonsillectomy* / adverse effects
  • Tonsillectomy* / methods