Impact of COVID-19 on development and course of chronic adenotonsillar diseases in children

Background: Chronic adenotonsillar disease is highly prevalent in pediatric populations. The functional status of the Waldeyer’s lymphoepithelial pharyngeal ring plays a key role in the body’s immune response to respiratory viruses. SARS-CoV-2 infection may aggravate the course of chronic adenotonsillar disease, possibly due to the virus’s prolonged persistence in the tissues of the lymphoepithelial pharyngeal ring.

Aim: To identify factors contributing to the development and progression of chronic adenotonsillar disease in children following COVID-19.

Methods: A prospective cohort study was conducted involving 135 children hospitalized at Filatov Children’s City Hospital No. 5 (Saint Petersburg) with symptoms of acute respiratory viral infection. Participants were divided into groups with and without pre-existing chronic adenotonsillar disease. Clinical assessments included general medical examination, otorhinolaryngological assessment, laboratory tests, and PCR testing for SARS-CoV-2 and other respiratory viruses. A follow-up examination at 6 months included a full otorhinolaryngological assessment to identify chronic adenotonsillar symptoms and determine the need for surgical intervention. Statistical analysis was performed using the Mann–Whitney U test and Pearson’s chi-square test (χ²).

Results: Significant factors associated with the development of chronic adenotonsillar disease included prior COVID-19, concurrent viral infections, frequent ARVI episodes, and elevated erythrocyte sedimentation rate. Factors significantly associated with the need for surgical intervention included prior COVID-19, preschool age, and absence of typical throat pain complaints.

Conclusion: COVID-19 significantly increases the risk of developing and progressing chronic adenotonsillar disease, particularly in preschool-aged children, emphasizing the need for further research into its pathogenesis and preventive strategies.