Background: Since the outbreak of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a decline in pediatric emergency department visits. Our aim was to assess the pattern of pediatric foreign body aspiration (FBA) during the first year of the COVID-19, in comparison to the prior years. Methods: In this retrospective multicenter study, we compared the number of children that presented with FBA during the COVID-19 year (March 1st, 2020 to February 28, 2021), to the annual average of the years 2016-2019. We also compared the lockdown periods to the post-lockdown periods and the percentage of missed FBA, proven FBA, and flexible bronchoscopy as the removal procedure. Results: 345 children with FBA from six centers were included, 276 in the pre-COVID-19 years (average 69 per year) and 69 in the COVID-19 year. There was no difference in the prevalence of FBA between the COVID-19 year and any of the prior four years. Examining the lockdown effect, the monthly incidence of FBA dropped from a pre-COVID-19 average of 5.75 cases to 5.1 cases during lockdown periods and increased to 6.3 cases in post-lockdown periods. No difference in the percentage of missed FB or proven FB was observed. There was a significant rise in the usage of flexible bronchoscopy as the removal procedure (Average of 15.4% vs 30.4%, p=0.001) Conclusion: There was no difference in the prevalence of FBA during the COVID-19 year. However, there were fewer cases during lockdown periods, compared to post-lockdown periods, presumably related to better parental supervision.

Introduction: Although the association between necrotizing otitis externa (NOE) and diabetes mellitus (DM) is well known, there is little knowledge in regards to the effects of DM and glycemic control (preadmission and during hospitalization) on the outcome of NOE. The aim of the study was to determine the effects of DM duration and preadmission glycemic control, and in-hospital glycemic control on NOE severity. Methods: A retrospective case series analysis, including all patients between the years 1990-2018 hospitalized due to NOE were included in the study. Data collected included NOE disease characteristics, duration of DM, DM associated comorbidities, glycated hemoglobin (HbA1c), urine micro-albumin and in-hospital blood glucose measurements. Disease severity was defined based on duration of hospitalization (above or below 20 days) and need for surgery. Results: Eighty nine patients were included in the study. Eighty three patients (94.3%) had DM. Preadmission HbA1c was 8.13% (5.8%-12.6%). Forty nine patients (65.5%) had mean blood glucose of ≥140mg\dL and 26 patients (34.5%) had ≤ 140mg/dL. DM duration was 157.88 months among NOE patients who required surgery, and 127.6 months among patients who were treated conservatively (p-value 0.25). HbA1c in patients hospitalized < 20 days was 7.6%, and 8.7% among NOE hospitalized ≥ 20 days (p-value 0.027). Seven patients with mean blood glucose of ≤140mg\dL had Pseudomonas Aeruginosa (PA-NOE) (26.7%), in comparison to 25 patients (51.0%) with mean blood glucose measurement of ≥140mg\dL (p=0.045). Conclusions: HbA1c levels at admission are associated with longer hospitalization duration among NOE patients. High mean blood glucose during hospitalization was associated with a higher likelihood for a PA infection, however it had no effect on disease outcome.