Comparative Analysis of Varicella Complications in Pediatric Hospitalized Patients before and After the COVID-19 Pandemic

Document Type : original article

Authors

1 Medical Doctor, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Pediatric, Faculity of Medicine, Mashhad University of Medical Siences, Mashhad, Iran

10.22038/jpp.2026.95060.5635

Abstract

Chickenpox is a common viral illness in children, typically mild, but it can lead to severe complications and even death. The COVID-19 pandemic and related social, healthcare, and environmental changes may have altered disease patterns and outcomes. This retrospective cross-sectional study examined hospitalization trends and complications in 390 children under 18 years admitted with chickenpox between 2017 and 2024 (1396–1403). Demographics, clinical complications, treatment interventions, and discharge outcomes were extracted from the Hospital Information System (HIS) and analyzed using SPSS v26.

Before the pandemic, hospitalizations and complications were infrequent, reflecting generally mild disease. After the pandemic, both the number of hospitalized children and the severity of complications increased markedly, with nearly half of patients in 2023 (1402) experiencing significant complications. Common complications included cellulitis (21%), pneumonia (14%), and arthritis (3.3%). Approximately 15% required intensive care, with an average ICU stay of 3.96 days, and several children developed rare but serious conditions such as toxic shock syndrome. Notably, 10% had underlying immunodeficiencies, increasing their vulnerability.

These findings highlight a concerning post-pandemic shift, emphasizing the human cost of delayed vaccination, healthcare access challenges, and environmental and viral factors. Early identification of high-risk children, vigilant clinical monitoring, and strengthened preventive measures are essential to reduce morbidity and mortality, safeguarding the well-being of vulnerable pediatric populations.

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