Timing of Pediatric Cochlear Implant Care During COVID-19

ABSTRACT

Introduction: The COVID-19 pandemic has resulted in delayed provision of essential and nonessential medical care. The objective of this study was to identify trends and possible delays in the timing of pediatric cochlear implant (CI) preand postoperative care during COVID-19 compared with pre- COVID at a single center. Method(s) Patients under the age of 18 years old who underwent initial CI at a single tertiary care center between January 1, 2016, and February 29, 2020, were included in the pre- COVID-19 group, and patients implanted between March 1, 2020, and December 31, 2021, were included in the COVID- 19 group. Data from revision or sequential second-side CI surgeries were excluded. Time intervals between care milestones including confirmation of severe to profound hearing loss, CI surgery, and CI activation were compared for the pre- COVID-19 and COVID-19 groups, as were the number and type (virtual vs in person) of postoperative visits. Result(s) A total of 98 patients met inclusion criteria, of which 70 were implanted pre-COVID and 28 during COVID. At the time of first CI, patients in the COVID group were significantly older (mu=5.7 years, 95% CI, 4.0-7.5) compared with patients in the pre-COVID group (mu=3.7 years, 95% CI, 2.9-4.6;P=.02). The interval between severe to profound hearing loss confirmation and first CI surgery was significantly longer for the COVID group (mu=99.7 weeks, 95% CI, 48.8-150) compared with the pre-COVID group (mu=54.2 weeks, 95% CI, 39.6-68.8;P=.02). All patients underwent activation within 7 weeks after implantation, although the time between first CI surgery and activation was significantly shorter for the COVID group (mu=3.8 weeks, 95% CI, 3.6-4.0) compared with the pre-COVID group (mu=4.3 weeks, 95% CI, 4.1-4.5;P=.01). Conclusion(s) Pediatric patients undergoing cochlear implantation during the COVID-19 pandemic experienced significant delays in care. Future work will aim to reveal impact of delayed care on outcomes in this population.