Impact of the COVID-19 Pandemic on Odontogenic Abscess Clinical Patterns and Predictive Factors: A Retrospective Cross-Sectional Study

TL;DR

This study examines how the COVID-19 pandemic affected the clinical patterns and outcomes of dental abscesses, finding no major changes but identifying key factors that influence hospital stays and reoperations.

Contribution

The study identifies specific predictive factors for hospitalization and reoperation in odontogenic abscesses during the pandemic.

Findings

Elevated procalcitonin and C-reactive protein levels were linked to longer hospital stays.

Prior outpatient antibiotic use and comorbidities increased the risk of reoperation.

Maintaining dental services is crucial to prevent severe infections during healthcare disruptions.

Abstract

Background/Objectives: The COVID-19 pandemic disrupted healthcare systems globally, with dental services significantly limited due to infection control measures. This study investigates the impact of the pandemic on the clinical presentation, management, and outcomes of odontogenic abscesses over three distinct periods. Methods: A retrospective study was conducted at University Clinical Hospital (Poznan, Poland), which included adult patients hospitalised for odontogenic infections between March 2019 and February 2022. The cohort comprised 101 patients (median age: 33 years; 59.41% male), with admissions distributed across pre-pandemic (37.62%), pandemic (19.80%), and post-pandemic (42.57%) periods. Clinical, biochemical, and radiographic data were analysed. Results: No statistically significant differences were found between periods for abscess severity, hospitalisation length, or inflammatory marker levels. Elevated procalcitonin (Rs = 0.289, p = 0.005), C-reactive protein (Rs = 0.385, p < 0.001), and body mass index (Rs = 0.253, p = 0.011) independently predicted longer hospital stays. In regression modelling, procalcitonin (β = 0.464, p = 0.001) and prior outpatient antibiotic use (β = 0.281, p = 0.038) were mainly associated with larger abscess volumes, while comorbidities (β = 0.262, p = 0.025), longer hospitalisation (β = 0.594, p = 0.001) and abscess volume (β = −0.294, p = 0.040) increased the risk of reoperation. Conclusions: The study highlights clinically important findings linked to delayed dental care and increased systemic inflammation related to the pandemic. Elevated procalcitonin and CRP levels provide prognostic information that can guide early triage, risk stratification, and decisions regarding surgical versus outpatient management. These findings emphasise the importance of maintaining essential dental services, implementing preventive strategies, and optimising management protocols to reduce the risk of severe infections and improve patient outcomes during healthcare disruptions.

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