BACKGROUND: Foreign body (FB) ingestion is a common otolaryngologic problem in the emergency department (ED). COVID-19 has been sweeping the globe since early 2020 and has changed daily life substantially, especially for those in the medical service. This study evaluated the association between the presence of the COVID-19 pandemic and the management of FB ingestion.
METHODS: The medical records for patients with FB ingestion from January 1 to December 31, 2020, and from January 1, 2017, to December 31, 2018, in the ED of National Cheng Kung University Hospital (NCKUH), Tainan, Taiwan, were analyzed retrospectively. Clinical characteristics, including age, sex, FB type, FB location, and examinations received, were collected for analysis.
RESULTS: A total of 947 FB ingestion cases were enrolled in the 2020 group. Of that total, 494 patients (52.2%) had the FB successfully removed and, 453 patients (47.8%) had no FB removed. In the 2020 cohort, 469 patients (49.5%) were men, and fish bone was the most common type of FB. Compared with the 2078 cases in the 2017–2018 cohort, the 2020 FB cohort had a higher proportion of patients aged older than 60 years (29.1% vs. 24.5%, p = 0.039), a higher proportion of FB found in the oropharynx (excluding tonsil) (57% vs. 51.2%) but a lower proportion in the tonsillar region (18.1% vs. 23.3%, p = 0.011), and received fewer rigid esophagoscope (RE) procedures (0.4% vs. 1.6%, p < 0.01). No significant difference was observed between the two groups in terms of sex, types of FB, the success rate for FB removal, or the time interval between the onset of FB ingestion and the time of seeking ED medical care.
CONCLUSIONS: In 2020, a peak COVID-19 pandemic year, FB ingestion cases in the NCKUH ED were approximately 10% lower than in 2017–2018. Moreover, a greater number of older patients experienced FB impaction, and the otolaryngologist had fewer opportunities to perform RE procedures. COVID-19 has not only been a cruel lesson for the world, but it has also drastically altered otolaryngologic intervention for FB ingestion. (J Taiwan Otolaryngol Head Neck Surg 2022; 57:266-275)
