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Has the COVID-19 Pandemic Affected Vulvovaginitis in Prepuberty and Adolescent Females in China? A Retrospective Study of 4644 Cases during 2018-2021

Gao H, Wang S, Zhou M, Zhang Y, Cheung C, Chan SSC, Yuan C, Sun L

Journal of pediatric and adolescent gynecology, 2025

Abstract

OBJECTIVE: Vulvovaginitis (VV) is one of the most common gynecologic complaints in prepubertal and adolescent girls. However, data on the impact of the COVID-19 pandemic on VV in this population are limited. This study aimed to explore changes in the epidemiology, pathogenic patterns, and antibiotic susceptibility of VV in girls before and during the COVID-19 pandemic in China.

METHODS: A retrospective study was conducted in girls aged 0-18 years who were diagnosed with VV from January 2018 to December 2021.

RESULTS: A total of 4644 cases of VV were identified, including 2427 cases from 2018 to 2019 (before the COVID-19 pandemic) and 2217 cases from 2020 to 2021 (during the COVID-19 pandemic). The proportion of VV cases in the 0-6-year age group decreased significantly from 40.2% to 31.3%, whereas the proportion in the 10-18-year age group increased from 30.1% to 39.6%. The major pathogens identified from 2020 to 2021 were similar to those detected from 2018 to 2019. The detection rates of Haemophilus influenzae, Streptococcus pyogenes, and Streptococcus pneumoniae decreased during the COVID-19 pandemic. In contrast, the detection rates of Escherichia coli, Klebsiella pneumoniae, and Candida albicans increased. Antibiotic susceptibility testing revealed that the sensitivity of H. influenzae to ampicillin/sulbactam and amoxicillin/clavulanate increased by 5.6% and 13.4%, respectively, after the pandemic. In contrast, levofloxacin sensitivity in E. coli decreased by 20.3%…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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