COVID-19 Pandemic Linked to Rise in Severe GAS Infections in Children

Strategic Insights -

A study published in the Pediatric Infectious Disease Journal found a significant increase in severe Group A Streptococcus (GAS) infections in children during the late COVID-19 pandemic period in Paris, France. The research, conducted from 2018 to 2023, revealed that the incidence of severe GAS infections decreased by 83% during the early pandemic period but increased significantly in the late pandemic period, returning to prepandemic levels post-pandemic. The study also found that late pandemic cases were more severe, with longer hospital stays, more forms of invasive GAS, and increased proportions of pleural empyema and bone and joint infections.

Key Takeaways:

  • The COVID-19 pandemic led to a significant increase in severe GAS infections in children in Paris, France, with a rise in incidence and severity during the late pandemic period.
  • The incidence of severe GAS infections decreased by 83% during the early pandemic period but increased by 65% in the late pandemic period.
  • Post-pandemic, the incidence of severe GAS infections returned to prepandemic levels.
  • Late pandemic cases were more severe, with longer hospital stays (9.4 vs. 6.4 days; P = 0.0007), more forms of invasive GAS (47% vs. 28%; P = 0.001), increased proportions of pleural empyema (15% vs. 4%) and bone and joint infections (14% vs. 7%; P = 0.008), and more complicated ENT infections (22% vs. 7%; P = 0.003).
  • The study concluded that the findings may improve preparedness in future pandemics.

Statistics:

  • 269 children with severe GAS infections were included in the study, with a mean age of 4.0 +/- 4.0 years.
  • Most cases were severe ear-nose-throat (ENT) infections (192/269, 71%), followed by bone and joint infections (10%) and pleural empyema (8%).
  • The incidence rate ratio (IRR) for GAS infections during the early pandemic period was 0.17 (95% CI: 0.10-0.27).
  • The IRR for GAS infections during the late pandemic period was 1.65 (95% CI: 1.22-2.24).
  • The IRR for GAS infections during the post-pandemic period was 0.97 (95% CI: 0.68-1.38).

Sources:

  • Severe Group a streptococcus Infections In Children During and After the Covid-19 Pandemic: an Interrupted Time-series Analysis In Paris, France, 2018-2023. Pediatric Infectious Disease Journal, 2025;44(10):973-978.
  • Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.
  • Jeremie F. Cohen, University of Paris Cite, Necker Hospital for Sick Children (INEM), Public Assistance - Paris Hospitals (AP-HP), Gen Pediat & Pediat Infect Dis, 149 Rue Sevres, F-75015 Paris, France.