COVID-19 and Orbital Cellulitis: Analysis of Circulating Viral Rates on Incidence and Admissions

Objective/HypothesisTo evaluate the incidence of hospitalization for orbital cellulitis in comparison to the rates of circulating viral infections during and prior to the COVID-19 pandemic.Study DesignRetrospective Database Study.MethodsUsing the Georgia State Inpatient Database (SID) from 2018 to 2020 and the ICD-10 diagnosis codes for orbital cellulitis, incidence rates were determined on a month-to-month basis by date of hospitalization. Rates for circulating respiratory viruses for the state of Georgia during the study years were obtained through the Centers for Disease Control and Prevention (CDC). Statistical comparisons were made using a Pearson's Correlation Coefficient (r) for trends and unpaired t-test with statistical significance assessed by an alpha level of 0.05.ResultsIn the state of Georgia, the rates of hospitalization for orbital cellulitis significantly decreased during the COVID-19 pandemic versus pre-pandemic rates. A significant positive correlation was found for pediatric orbital cellulitis hospitalizations and total rates of circulating respiratory viral pathogens as well as individual viral rates of respiratory syncytial virus, influenza, parainfluenza type 4, and respiratory adenovirus. Rates prior to the pandemic remained fairly constant for the adult population regardless of the predominant circulating respiratory viral rates.ConclusionsDuring the COVID-19 pandemic with SARs-COV-2 as the predominant circulating viral infection, the rates of orbital cellulitis decreased. Positive correlations were found in pediatric cases with several circulating respiratory viruses. This is the first study to use population data to show that circulating respiratory viral rates impact the incidence of orbital cellulitis.Level of EvidenceIII