TY - JOUR T1 - THE EFFECT OF PREVIOUS ADENOTONSILLECTOMY ON THE RISK OF CONTRACTING COVID-19 AND THE SEVERITY OF THE DISEASE IN PEDIATRIC POPULATION TT - PEDİATRİK POPÜLASYONDA GEÇİRİLMİŞ ADENOTONSİLLEKTOMİNİN COVID-19'A YAKALANMA RİSKİ VE HASTALIĞIN ŞİDDETİ ÜZERİNDEKİ ETKİSİ AU - Okur, Engin AU - Kara, Ahmet AU - Elden, Halil PY - 2025 DA - February Y2 - 2024 DO - 10.53446/actamednicomedia.1475004 JF - Acta Medica Nicomedia JO - Acta Med Nicomedia PB - Kocaeli University WT - DergiPark SN - 2717-8994 SP - 1 EP - 4 VL - 8 IS - 1 LA - en AB - Objective: The effect of the Waldeyer’s lymphatic ring at the entry point of respiratory pathogens has essential functions in forming the immune response in childhood, and its effect on the frequency and severity of Coronavirus disease 2019 (Covid-19) is not clearly known. The objective of this study is to analyze the occurrence and severity of Covid-19 in pediatric patients undergoing adenotonsillectomy surgery.Methods: Patients aged 3-15 with a history of adenotonsillectomy were compared to a control group in terms of the incidence and severity of Covid-19.Results: In patients undergoing adenotonsillectomy, a Covid test positivity rate of 1.5% was observed, compared to 2.7% in the control group, indicating a statistically significant difference. However, there was no disparity between the two groups regarding disease severity.Conclusion: Adenotonsillectomy does not elevate the risk of Covid 19 infection in children. In fact, individuals who have undergone this surgery exhibit a decreased incidence of Covid-19 infection. KW - COVID-19 KW - coronavirus KW - adenotonsillectomy KW - immunity N2 - Amaç: Solunum yolu patojenlerinin giriş noktasındaki Waldeyer lenfatik halkasının etkisi, çocukluk çağında immün yanıtın oluşmasında önemli işlevlere sahip olup, Covid-19 hastalığının sıklığı ve şiddeti üzerine etkisi net olarak bilinmemektedir. Bu çalışmanın amacı adenotonsillektomi ameliyatı geçiren çocuk hastalarda Covid-19 hastalığının ortaya çıkışını ve ciddiyetini analiz etmektir.Yöntem: Adenotonsillektomi öyküsü olan 3-15 yaş arası hastalar, Covid-19 hastalığının görülme sıklığı ve şiddeti açısından kontrol grubuyla karşılaştırıldı.Bulgular: Adenotonsillektomi yapılan hastalarda Covid testi pozitiflik oranı %1,5, kontrol grubunda ise %2,7 olarak görüldü ve bu da istatistiksel olarak anlamlı bir farka işaret ediyor. Ancak hastalığın şiddeti açısından iki grup arasında fark yoktu.Sonuç: Adenotonsillektomi çocuklarda Covid 19 enfeksiyonu riskini artırmamaktadır. Aslında bu ameliyatı geçiren kişilerde Covid-19 enfeksiyonu görülme sıklığında azalma görülüyor.Anahtar Kelimeler: COVİD-19, coronavirüs, adenotonsillektomi, bağışıklık CR - 1. World Health Organization. Children and adolescents: COVID-19. WHO; 2021. https://www.who.int/publications-detail-redirect/WHO- 2019-nCoV-Sci_Brief-Children_and_adolescents-2021.1. CR - 2. American Academy of Pediatrics. Children and COVID-19: State-level data report. American Academy of Pediatrics; 2021. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/. CR - 3. Mantovani A, Rinaldi E, Zusi C, Beatrice G, Saccomani MD, Dalbeni A. Coronavirus disease 2019 (COVID-19) in children and/or adolescents: a meta-analysis. Pediatr Res. 2021;89(4):733-737. doi:10.1038/s41390-020-1015-2 CR - 4. Kari JA, Shalaby MA, Albanna AS, et al. Coronavirus disease in children: A multicentre study from the Kingdom of Saudi Arabia. J Infect Public Health. 2021;14(4):543-549. doi:10.1016/j.jiph.2021.01.011 CR - 5. Tezer H, Bedir Demirdağ T. Novel coronavirus disease (COVID-19) in children. Turk J Med Sci. 2020;50(SI-1):592-603. doi:10.3906/sag-2004-174 CR - 6. Brodin P. Why is COVID-19 so mild in children?. Acta Paediatr. 2020;109(6):1082-1083. doi:10.1111/apa.15271 CR - 7. Onal M, Onal O, Turan A. Can secondary lymphoid organs exert a favorable effect on the mild course of COVID-19 in children?. Acta Otolaryngol. 2021;141(1):83-84. doi:10.1080/00016489.2020.1814965 CR - 8. Bitar MA, Dowli A, Mourad M. The effect of tonsillectomy on the immune system: A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2015;79(8):1184-1191. doi:10.1016/j.ijporl.2015.05.016 CR - 9. Li K, Fang Y, Li W, et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19). Eur Radiol. 2020;30(8):4407-4416. doi:10.1007/s00330-020-06817-6 CR - 10. Palabiyik F, Akcay N, Sevketoglu E, Hatipoglu N, Sari EE, Inci E. Imaging of Multisystem Inflammatory Disease in Children (MIS-C) Associated With COVID-19. Acad Radiol. 2021;28(9):1200-1208. doi:10.1016/j.acra.2021.05.030 CR - 11. Yan Y, Song Y, Liu Y, et al. Short- and long-term impacts of adenoidectomy with/without tonsillectomy on immune function of young children <3 years of age: A cohort study. Medicine (Baltimore). 2019;98(19):e15530. doi:10.1097/MD.0000000000015530 CR - 12. Byars SG, Stearns SC, Boomsma JJ. Association of Long-Term Risk of Respiratory, Allergic, and Infectious Diseases With Removal of Adenoids and Tonsils in Childhood. JAMA Otolaryngol Head Neck Surg. 2018;144(7):594-603. doi:10.1001/jamaoto.2018.0614 CR - 13. Choi HG, Park B, Sim S, Ahn SH. Tonsillectomy Does Not Reduce Upper Respiratory Infections: A National Cohort Study. PLoS One. 2016;11(12):e0169264. Published 2016 Dec 30. doi:10.1371/journal.pone.0169264 CR - 14. Chung SD, Hung SH, Lin HC, Chen KC. Decreased clinic visits for acute respiratory infections following an adult tonsillectomy: A population-based study. Am J Otolaryngol. 2017;38(4):488-491. doi:10.1016/j.amjoto.2017.05.004 CR - 15. Murugesan R, Sagar P, Kumar R, et al. Long Term Impact of Adeno-tonsillectomy on Immunity Against Respiratory Viral Infections; Evidence Deduced During COVID-19 Pandemic. Indian J Pediatr. Published online May 7, 2024. doi:10.1007/s12098-024-05125-x CR - 16. Kara A, Elden H, Okur E, et al. Impact of tonsillectomy on COVID-19 pandemic: an observational study of the incidence and prognosis. Acta Otolaryngol. 2021;141(9):857-859. doi:10.1080/00016489.2021.1970803 CR - 17. Yang Y, Hu K, Modig K, et al. Surgical removal of tonsils and risk of COVID-19: a nested case-control study using data from UK Biobank and AMORIS Cohort. BMC Med. 2024;22(1):460. doi:10.1186/s12916-024-03587-6 CR - 18. Kaygusuz I, Alpay HC, Gödekmerdan A, et al. Evaluation of long-term impacts of tonsillectomy on immune functions of children: a follow-up study. Int J Pediatr Otorhinolaryngol. 2009;73(3):445-449. doi:10.1016/j.ijporl.2008.11.014 CR - 19. Mücke W, Huber HC, Ritter U. Mitteilung über die Keimbesiedelung der Gaumenmandeln bei gesunden Kindern im Einschulalter [The microbe colonization of the palatine tonsils of healthy school age children]. Zentralbl Hyg Umweltmed. 1994;196(1):70-74. CR - 20. Endo LH, Ferreira D, Montenegro MC, et al. Detection of Epstein-Barr virus in tonsillar tissue of children and the relationship with recurrent tonsillitis. Int J Pediatr Otorhinolaryngol. 2001;58(1):9-15. doi:10.1016/s0165-5876(00)00446-8 CR - 21. Agren K, Andersson U, Litton M, Funa K, Nordlander B, Andersson J. The production of immunoregulatory cytokines is localized to the extrafollicular area of human tonsils [published correction appears in Acta Otolaryngol (Stockh) 1996;116(6):918]. Acta Otolaryngol. 1996;116(3):477-485. doi:10.3109/00016489609137876 CR - 22. Johnson BS, Laloraya M. A cytokine super cyclone in COVID-19 patients with risk factors: the therapeutic potential of BCG immunization. Cytokine Growth Factor Rev. 2020;54:32-42. doi:10.1016/j.cytogfr.2020.06.014 CR - 23. Chiang PH, Liu HK, Chen YL, Wang YH, Wei JC. Association between tonsillectomy and COVID-19 in chronic tonsillitis patients. Br J Surg. 2023;110(11):1553-1554. doi:10.1093/bjs/znad291 UR - https://doi.org/10.53446/actamednicomedia.1475004 L1 - https://dergipark.org.tr/en/download/article-file/3891319 ER -