Surge of Pediatric Respiratory Tract Infections After the COVID-19 Pandemic and the Concept of "Immune Debt".

IF 3.9 2区 医学 Q1 PEDIATRICS
Lea Lenglart, Luigi Titomanlio, Zsolt Bognar, Silvia Bressan, Danilo Buonsenso, Tisham De, Ruth Farrugia, Kate Honeyford, Ian K Maconochie, Henriette A Moll, Rianne Oostenbrink, Niccolo Parri, Damian Roland, Esra Akyüz Özkan, Laura Almeida, Ilaria Alberti, François Angoulvant, Zein Assad, Camille Aupiais, Michael Barrett, Romain Basmaci, Dorine Borensztajn, Susana Castanhinha, Antonio Chiaretti, Robert Cohen, Sheena Durnin, Patrick Fitzpatrick, Susanne Greber-Platzer, Romain Guedj, Florian Hey, Lina Jankauskaite, Kristina Keitel, Ines Mascarenhas, Gregorio P Milani, Anna Maria Musolino, Zanda Pučuka, Malin Ryd Rinder, Maria Chiara Supino, Francesca Tirelli, Ruud G Nijman, Naim Ouldali
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引用次数: 0

Abstract

Objective: To investigate a dose-response relationship between the magnitude of decrease in pediatric respiratory tract infections (RTI) during the 2020 implementation of non-pharmaceutical interventions (NPI) and the rise thereafter during NPI lifting.

Study design: We conducted an interrupted, time-series analysis, based on a multinational surveillance system. All patients <16 years of age coming to medical attention with various symptoms and signs of RTI at 25 pediatric emergency departments from 13 European countries between January 2018 and June 2022 were included. We used generalized additive models to correlate the magnitude of decrease of each RTI during NPI (such as social distancing) implementation and its subsequent increase during NPI lifting. Urinary tract infections (UTI) served as control outcome.

Results: 528,055 patients were included. We observed reductions in cases during the NPI period, from -76% (95%CI -113;-53) in pneumonia) to -65% (95%CI[-100;-39) for tonsillitis/pharyngitis), followed by strong increases during NPI lifting, from +83% (95%CI 29;150) for tonsillitis/pharyngitis) to +329% (95%CI (149;517) bronchiolitis). For each RTI, we found a significant association between the magnitude of decrease during NPI implementation and the increase during NPI lifting. UTI cases remained stable.

Conclusions: The magnitude of increase in RTI observed following NPI lifting was directly correlated to the magnitude of cases' reduction during NPI implementation, suggesting a "dose-response" relationship from an "immune debt" phenomenon. The likely rebound in RTIs should be expected when implementing and lifting NPI in the future.

COVID-19 大流行后小儿呼吸道感染的激增与 "免疫债务 "的概念。
目的研究设计:研究设计:我们基于多国监测系统进行了间断时间序列分析。所有患者 结果:共纳入 528 055 名患者。我们观察到病例数在非疫情期间有所减少,从肺炎的-76%(95%CI -113;-53)到扁桃体炎/咽炎的-65%(95%CI[-100;-39)),随后在非疫情解除期间大幅增加,从扁桃体炎/咽炎的+83%(95%CI 29;150)到支气管炎的+329%(95%CI (149;517))。对于每种 RTI,我们发现在实施 NPI 期间减少的幅度与取消 NPI 期间增加的幅度之间存在显著关联。尿毒症病例保持稳定:结论:取消 NPI 后观察到的 RTI 增加幅度与 NPI 实施期间病例减少幅度直接相关,这表明 "免疫债务 "现象产生了 "剂量-反应 "关系。今后在实施和取消 NPI 时,应预计 RTI 可能会出现反弹。
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来源期刊
Journal of Pediatrics
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.
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