Skin and soft tissue infection incidence before and during the COVID-19 pandemic.
Skin and soft tissue infection incidence before and during the COVID-19 pandemic.
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DOI：
10.1017/s0950268823001802
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发表时间：
2023-11-06
影响因子：
4.2
通讯作者：
Miller, Loren G.
中科院分区：
文献类型：
--
作者：
Merino, Prudencio;Kupferwasser, Deborah;Flores, Evelyn A.;Tran, Donna Phan;Ortega, Abisay;Miller, Loren G.
皮肤和软组织感染（SSTI）是常见的细菌感染。我们假设，由于COVID-19大流行，SSTI率将大幅下降，因为指令避免不必要的护理和减弱SSTI的风险行为。我们回顾性检查了2017年3月16日至2022年3月15日期间美国第二大安全网医疗保健系统洛杉矶县卫生服务部的所有ICD-10诊断代码患者。然后，我们使用中断时间序列分析比较了大流行前和大流行内的SSTI率。我们发现了72，118例SSTI，其中46，206例发生在大流行前，25，912例发生在大流行期间。大流行前SSTI发病率显著高于大流行期间的发病率（3.27例/1，000个配备的患者月对2.31例/1，000个配备的患者月，P < 0.0001）。在大流行前和大流行期间，每月SSTI病例减少了1.19个SSTI/1,000个配备患者月（P = 0.0003）。SSTI亚组（住院、观察单位、急诊科和门诊），除观察单位（P = 0.50）外，两个时间段之间的SSTI均显著降低（P <0.05）。与2019冠状病毒病大流行前的时期相比，我们的美国大型安全网医疗保健系统中有医生参与的SSTI比率大幅下降近30%。调查结果是否反映了真正的SSTI下降或SSTI的卫生系统利用率下降，需要进一步检查。
Skin and Soft Tissue Infections (SSTIs) are common bacterial infections. We hypothesized that due to the COVID-19 pandemic, SSTI rates would significantly decrease due to directives to avoid unneeded care and attenuated SSTIs risk behaviours. We retrospectively examined all patients with an ICD-10 diagnosis code in the Los Angeles County Department of Health Services, the second largest U.S. safety net healthcare system between 16 March 2017 and 15 March 2022. We then compared pre-pandemic with intra-pandemic SSTI rates using an interrupted time series analysis. We found 72,118 SSTIs, 46,206 during the pre-pandemic period and 25,912 during the intra-pandemic period. Pre-pandemic SSTI rate was significantly higher than the intra-pandemic rate (3.27 vs. 2.31 cases per 1,000 empanelled patient-months, P < 0.0001). The monthly SSTI cases decreased by 1.19 SSTIs/1,000 empanelled patient-months between the pre- and intra-pandemic periods (P = 0.0003). SSTI subgroups (inpatient, observation unit, emergency department, and outpatient clinics), all had significant SSTI decreases between the two time periods (P < 0.05) except for observation unit (P = 0.50). Compared to the pre-COVID-19 pandemic period, medically attended SSTI rates in our large U.S. safety net healthcare system significantly decreased by nearly 30%. Whether findings reflect true SSTI decreases or decreased health system utilization for SSTIs requires further examination.