Effect of lockdowns on the epidemiology of pediatric respiratory disease-A retrospective analysis of the 2021 summer epidemic.
COVID-19
ED visits
SARS-CoV-2
admissions
asthma
bronchiolitis
corona
lockdown
pediatrics
pneumonia
wheezing
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
revised:
13
01
2023
received:
10
09
2022
accepted:
19
01
2023
pubmed:
26
1
2023
medline:
21
3
2023
entrez:
25
1
2023
Statut:
ppublish
Résumé
The imposition of lockdowns during the severe acute respiratory syndrome coronavirus-2 pandemic led to a significant decrease in pediatric care utilization in 2020. After restrictions were loosened, a surge in pediatric respiratory disease was observed in pediatric wards. The aim of this study was to quantify the effect of the lockdown(s) on the incidence of pediatric respiratory disease. For this multicenter retrospective study, emergency department (ED) visit and admission data between January 2017 and September 2021 was collected from eight general hospitals in the Netherlands. Clinical diagnoses were extracted and categorized in groups ("communicable infectious disease," "all respiratory infections," "upper respiratory tract infection," "lower respiratory tract infection," and "asthma/preschool wheezing"). The incidence of admissions and ED visits during 2020 and 2021 was compared to the incidence in 2017-2019. Successive lockdowns resulted in a maximum decrease of 61% and 57% in ED visits and admissions, respectively. After loosening restrictions during the summer of 2021, a 48% overall increase in ED visits and 31% overall increase in admission numbers was observed in July compared to the average July in 2017-2019. This was explained by a 381% increase in ED visits and a 528% increase in ward admissions due to overall respiratory infections, mainly due to lower respiratory tract infections. Successive lockdowns in the spring and winter of 2020 and 2021 led to a decreased incidence of communicable infections, especially respiratory tract infections. The resulting lack of pediatric immunity resulted in an off-season surge in care utilization at an unexpected moment.
Sections du résumé
BACKGROUND
The imposition of lockdowns during the severe acute respiratory syndrome coronavirus-2 pandemic led to a significant decrease in pediatric care utilization in 2020. After restrictions were loosened, a surge in pediatric respiratory disease was observed in pediatric wards. The aim of this study was to quantify the effect of the lockdown(s) on the incidence of pediatric respiratory disease.
METHODS
For this multicenter retrospective study, emergency department (ED) visit and admission data between January 2017 and September 2021 was collected from eight general hospitals in the Netherlands. Clinical diagnoses were extracted and categorized in groups ("communicable infectious disease," "all respiratory infections," "upper respiratory tract infection," "lower respiratory tract infection," and "asthma/preschool wheezing"). The incidence of admissions and ED visits during 2020 and 2021 was compared to the incidence in 2017-2019.
RESULTS
Successive lockdowns resulted in a maximum decrease of 61% and 57% in ED visits and admissions, respectively. After loosening restrictions during the summer of 2021, a 48% overall increase in ED visits and 31% overall increase in admission numbers was observed in July compared to the average July in 2017-2019. This was explained by a 381% increase in ED visits and a 528% increase in ward admissions due to overall respiratory infections, mainly due to lower respiratory tract infections.
CONCLUSIONS
Successive lockdowns in the spring and winter of 2020 and 2021 led to a decreased incidence of communicable infections, especially respiratory tract infections. The resulting lack of pediatric immunity resulted in an off-season surge in care utilization at an unexpected moment.
Types de publication
Multicenter Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1229-1236Informations de copyright
© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.
Références
Liu Y-C, Kuo R-L, Shih S-R. COVID-19: the first documented coronavirus pandemic in history. Biomed J. 2020;43:328-333. doi:10.1016/j.bj.2020.04.007
Kruizinga MD, Peeters D, van Veen M, et al. The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature. Eur J Pediatr. 2021;180:2271-2279. doi:10.1007/s00431-021-04015-0
Di Mattia G, Nenna R, Mancino E, et al. During the COVID-19 pandemic where has respiratory syncytial virus gone? Pediatr Pulmonol. 2021;56:3106-3109. doi:10.1002/ppul.25582
van Summeren J, Meijer A, Aspelund G, et al. Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Eurosurveillance. 2021;26:2100639. doi:10.2807/1560-7917.ES.2021.26.29.2100639
Cohen R, Ashman M, Taha MK, et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Infect Dis Now. 2021;51:418-423. doi:10.1016/j.idnow.2021.05.004
Maison N, Peck A, Illi S, et al. The rising of old foes: impact of lockdown periods on “non-SARS-CoV-2” viral respiratory and gastrointestinal infections. Infection. 2022;50:519-524. doi:10.1007/s15010-022-01756-4
Foley DA, Phuong LK, Peplinski J, et al. Examining the entire delayed respiratory syncytial virus season in Western Australia. Arch Dis Child. 2022;107:517-519. doi:10.1136/archdischild-2021-322507
Saravanos GL, Hu N, Homaira N, et al. RSV epidemiology in Australia before and during COVID-19. Pediatrics. 2022;149:e2021053537. doi:10.1542/peds.2021-053537
Rijksoverheid.RIVM Coronavirus Timeline Netherlands. Rijksoverheid; 2022. https://www.rijksoverheid.nl/onderwerpen/coronavirus-tijdlijn
Methi F, Størdal K, Telle K, Larsen VB, Magnusson K. Hospital admissions for respiratory tract infections in children aged 0-5 years for 2017/2023. Front Pediatr. 2022;9:1-8. doi:10.3389/fped.2021.822985
Delestrain C, Danis K, Hau I, et al. Impact of COVID-19 social distancing on viral infection in France: a delayed outbreak of RSV. Pediatr Pulmonol. 2021;56:3669-3673. doi:10.1002/ppul.25644
Mattana G, Albitar-Nehme S, Cento V, et al. Back to the future (of common respiratory viruses). J Glob Antimicrob Resist. 2022;28:223-225. doi:10.1016/j.jgar.2022.01.010
Kuitunen I, Artama M, Haapanen M, Renko M. Record high parainfluenza season in children after relaxation of COVID-19 restrictions in fall 2021-a nationwide register study in Finland. Influenza Other Respir Viruses. 2022;16:613-616. doi:10.1111/irv.12983
Ujiie M, Tsuzuki S, Nakamoto T, Iwamoto N. Resurgence of respiratory syncytial virus infections during Covid-19 pandemic, Tokyo, Japan. Emerg Infect Dis. 2021;27:2969-2970. doi:10.3201/eid2711.211565
Hatter L, Eathorne A, Hills T, Bruce P, Beasley R. Respiratory syncytial virus: paying the immunity debt with interest. Lancet Child Adolesc Health. 2021;5:e44-e45.
Trento A, Rodríguez-Fernández R, González-Sánchez MI, et al. The complexity of antibody responses elicited against the respiratory syncytial virus glycoproteins in hospitalized children younger than 2 years. Front Microbiol. 2017;8:1-12. doi:10.3389/fmicb.2017.02301
Sears MR, Johnston NW. Understanding the September asthma epidemic. J Allergy Clin Immunol. 2007;120:526-529. doi:10.1016/j.jaci.2007.05.047
Larsen K, Zhu J, Feldman LY, et al. The annual September peak in asthma exacerbation rates still a reality? Ann Am Thorac Soc. 2016;13:231-239. doi:10.1513/AnnalsATS.201508-545OC
Kim WK. Association between respiratory viruses and asthma exacerbations. Korean J Pediatr. 2014;57:26-28. doi:10.3345/kjp.2014.57.1.26
Netherlands Youth Institute. Numbers About Birth. Netherlands Youth Institute; 2022. https://www.nji.nl/cijfers/geboorte#:%7E:text=Geboortecijfers,Toen%20waren%20er%20168.681%20levendgeborenen