Impact of Covid-19 on the incidence and severity of odontogenic infections in Fiji islands: a multicenter hospital-based retrospective study

Abstract

Background: Severe odontogenic infections (OIs), often associated with untreated dental caries, can lead to life-threatening complications. In Fiji, dental caries is highly prevalent, and during the COVID-19 pandemic, limited access to dental care may contributed to the progression of untreated lesions, potentially resulting in an increased number of severe OI cases. However, there is a lack of evidence from Fiji on this issue. Therefore, this study aimed to assess the impact of the COVID-19 pandemic on the presentation of patients with OIs. Methods: A retrospective, multicenter hospital-based study was conducted in Fiji, involving 260 participants who presented with odontogenic infections (OIs) during two time periods: pre-COVID-19 (March 2019 to February 2020) and during COVID-19 (March 2020 to February 2021). Collected variables included patient demographics, clinical presentation, etiological factors, and admission status. Data were analyzed using SPSS, with descriptive statistics and association tests conducted at a significance level of 0.05. Results: No statistically significant difference in the overall number of patients presenting with OIs was observed during the COVID-19 period. A higher proportion of cases occurred in patients under 30 years of age (62.8%), among the i-Taukei ethnic group (69.2%), and those residing in urban areas (48.1%), with a nearly equal distribution between males and females. The majority of cases were managed as outpatients (60.4%). Most infections involved a single fascial space and presented with a single clinical sign or symptom (76.9%). Dental caries was identified as the most common cause of infection (90.4%). While CWM Hospital and Lautoka Hospital reported a reduction in patient numbers (9.7% and 25%, respectively), Labasa Hospital recorded a significant increase in cases (34.7%, p < 0.001). Conclusion: There was no evidence of a change in the prevalence, admission rates, or severity of odontogenic infections (OIs) during the COVID-19 pandemic. However, a significant regional variation in patient distribution was observed, with Labasa Hospital experiencing a notable increase in cases, attributed to the absence of lockdown measures and COVID-related restrictions in that region.