Comparative Analysis of Bacterial Neuroinfections Before and During The COVID-19 Pandemic

Bacterial meningitis and meningoencephalitis are severe diseases that can be fatal or lead to permanent disability in survivors despite the availability of antibiotic therapy. After the emergence of SARS-CoV-2, changes in morbidity, hospitalizations and etiology have been observed in some countries.

Aim: The aim of this analysis was to compare the epidemiological and clinical characteristics of patients with bacterial neuroinfections before and during COVID-19.

Materials and methods: The study included 126 patients with bacterial neuroinfections, treated at the Clinic of Infectious Diseases, “Sveti Georgi” Univeristy Hospital in Plovdiv, during two equal periods – from January 2016 to September 2019 (shortly before COVID-19), and from March 2020 to December 2023 (during COVID-19), respectively. Clinical and epidemiological data, laboratory, microbiological, and molecular tests, as well as imaging techniques, were used.

Results: 90 patients with bacterial neuroinfections were hospitalized during the pre-COVID-19 period, whereas hospitalizations were only 36 during the COVID-19 period. In addition, seasonal, gender, and age distribution differences were observed. The etiology was similar in both observational periods, with the most common agents being S. pneumoniae, Staphylococcus spp., and L. monocytogenes. Mortality rate was similar (33.3% vs. 37.1%, respectively), but differences in terms of etiology were observed.

Conclusion: The significant reduction of bacteria I neuroinfections during the COVID-19 period is probably due to the public prevention and control measures introduced at the beginning of the pandemic. The emergence of new pathogens and the measures that society takes towards fighting them can have an impact on the epidemiology, clinical course, and prognosis of other diseases that are already known to humanity.