Trends in Pediatric Hospital Admissions Caused or Contributed by SARS-CoV-2 Infection in England

IF 3.9 2区医学 Q1 PEDIATRICS

Journal of Pediatrics Pub Date : 2024-10-18 DOI:10.1016/j.jpeds.2024.114370

Harrison Wilde BSc , Christopher Tomlinson MD, PhD , Bilal A. Mateen MD, PhD , David Selby PhD , Hari Krishnan Kanthimathinathan MD , Spiros Denaxas PhD , Seth Flaxman PhD , Sebastian Vollmer PhD , Christina Pagel PhD , Katherine Brown MD, MPH , CVD-COVID-UK/COVID-IMPACT Consortium

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引用次数: 0

Abstract

Objective

To investigate the changing characteristics of SARS-CoV-2–related pediatric hospital admissions over time.

Study design

This was a national, observational cohort study from July 1, 2020, to August 31, 2023, using English population-linked electronic health records. We identified 45 203 children younger than 18 years old in whom SARS-CoV-2 either caused or contributed to hospitalization, excluding those admitted with “incidental” infection. Studied outcomes were types of hospitalization and severe hospitalizations involving either critical care or pediatric inflammatory multisystem syndrome-temporally associated with SARS-CoV-2 (PIMS-TS).

Results

There were 45 920 SARS-CoV-2–related hospitalizations in children: 34 870 (75.9%) attributable to COVID-19; 1845 (4.0%) attributable to PIMS-TS; 8330 (18.1%) with SARS-CoV-2 as contributor to admission; and 875 (1.9%) acquired nosocomial SARS-CoV-2 infection. The most notable changes between the first 3 waves (March 2020 through November 2021) and the Omicron era (December 2021 onwards) were a decrease in PIMS-TS from 1575 of 14 020 (11.2%) to 270 of 31 905 (0.8%); a reduction in critical care use from 1175 of 14 020 (8.4%) to 1390 of 31 905 (4.4%); a decreased in mortality rate among those hospitalized from 521 per 100 000 to 249 per 100 000; and a decrease in the median age of hospitalized children from 4.7 (IQR 0.6,12.3) to 1.1 (IQR 0.3,6.4) years. Of children hospitalized, infants, 10.2% of whom had a recorded underlying health condition, comprised 4225 of 14 020 (30.1%) admissions 2020 through 2021 and 15 555 of 31 900 (48.8%) since 2022. (P < .001 for all comparisons).

Conclusions

Infants are now the pediatric age group most affected by SARS-CoV-2, at least partially because they have the least immunity to the virus, and are most vulnerable to respiratory illnesses.

查看原文本刊更多论文

英格兰由 SARS-CoV-2 感染引起或促成的儿科住院趋势。

研究目的研究设计：研究设计：2020 年 7 月 1 日至 2023 年 8 月 31 日期间进行的一项全国性观察性队列研究，使用的是与英国人口相关的电子健康记录。我们确定了 45203 名 18 岁以下因感染 SARS-CoV-2 或导致住院的儿童，其中不包括因 "偶然 "感染而住院的儿童。研究结果包括住院类型和涉及重症监护或 PIMS-TS 的严重住院情况：共有 45 920 名儿童因感染 SARS-CoV-2 而住院：34,870人（75.9%）因COVID-19而住院；1,845人（4.0%）因与SARS-CoV-2暂时相关的儿科多系统炎症综合征（PIMS-TS）而住院；8,330人（18.1%）因SARS-CoV-2而住院；875人（1.9%）因SARS-CoV-2感染而住院。前三波（2020 年 3 月至 2021 年 11 月）与欧米克时代（2021 年 12 月起）之间最显著的变化是：PIMS-TS 从 14,020 例中的 1,575 例（11.2%）下降到 31,905 例中的 270 例（0.8%）；重症监护使用从 14,020 例中的 1,175 例（8.住院儿童的中位年龄从 4.7（IQR 0.6-12.3）岁下降到 1.1（IQR 0.3-6.4）岁。在住院儿童中，2020 年至 2021 年的 14,020 人中有 4,225 名婴儿（占 30.1%）住院，2022 年以来的 31,900 人中有 15,555 名婴儿（占 48.8%）住院，其中 10.2%的婴儿有记录的基础健康状况。(结论：婴儿是目前受 SARS-CoV2 影响最严重的年龄组，这至少部分与婴儿对病毒的免疫力最低有关，而且婴儿最容易患呼吸道疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.