Indirect effects of the covid-19 pandemic on childhood infection in England: population based observational study.
Indirect effects of the covid-19 pandemic on childhood infection in England: population based observational study.
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DOI：
10.1136/bmj-2021-067519
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发表时间：
2022-01-12
期刊：
影响因子：
--
通讯作者：
Pollard AJ
中科院分区：
文献类型：
--
作者：
Kadambari S;Goldacre R;Morris E;Goldacre MJ;Pollard AJ
评估2019冠状病毒病大流行对英格兰儿童呼吸道感染、严重侵袭性感染和疫苗可预防疾病的住院率和死亡率结局的影响。对19种常见的儿童呼吸道、严重侵袭性和疫苗可预防感染进行的基于人群的观察性研究，比较了英格兰大流行病爆发前后的住院率和死亡率结果。从2017年3月1日至2021年6月30日，英格兰每家NHS医院的入院数据与国家死亡率数据的记录关联。从2017年3月1日至2021年6月30日，0-14岁的儿童因选定的儿童感染而入住NHS医院。对于每种感染，从2017年3月1日至2021年6月30日每月住院人数，2020年3月1日之前和之后住院人数的百分比变化，以及调整后的比值比，以比较2020年3月1日之前和之后的60天病死率结果。在2020年3月1日之后，除了研究的19种感染性疾病中的一种之外，所有感染性疾病的住院人数都大幅持续减少。在呼吸道感染中，流感下降的百分比最大（2017年3月1日至2020年2月29日期间的平均年度入院人数为5379人，2020年3月1日至2021年2月28日期间的入院儿童人数为304人，减少94%，95%置信区间为89%至97%），和细支气管炎（从51655到9423，减少82%，95%置信区间79%到84%）。在严重的侵袭性感染中，减少最多的是脑膜炎（减少50%，47%至52%）。对于疫苗可预防的感染，下降幅度从腮腺炎的53%（32%至68%）到麻疹的90%（80%至95%）不等。在所有人口统计学亚组和有潜在合并症的儿童中均观察到减少。60天内死亡病例的绝对数量也相应减少，尽管60天内因肺炎入院的儿童死亡比例增加（年龄-性别调整的比值比为1.71，95%置信区间为1.43至2.05）。最新数据表明，2021年5月后，一些呼吸道感染病例增加至高于平时的水平。在2019冠状病毒病大流行期间，一系列行为改变（采用非药物干预措施）和社会策略（关闭学校、封锁和限制旅行）被用来减少SARS-CoV-2的传播，这也减少了普通和严重儿童感染的入院人数。随着社会限制的演变，需要继续监测这些感染。
To assess the impact of the covid-19 pandemic on hospital admission rates and mortality outcomes for childhood respiratory infections, severe invasive infections, and vaccine preventable disease in England. Population based observational study of 19 common childhood respiratory, severe invasive, and vaccine preventable infections, comparing hospital admission rates and mortality outcomes before and after the onset of the pandemic in England. Hospital admission data from every NHS hospital in England from 1 March 2017 to 30 June 2021 with record linkage to national mortality data. Children aged 0-14 years admitted to an NHS hospital with a selected childhood infection from 1 March 2017 to 30 June 2021. For each infection, numbers of hospital admissions every month from 1 March 2017 to 30 June 2021, percentage changes in the number of hospital admissions before and after 1 March 2020, and adjusted odds ratios to compare 60 day case fatality outcomes before and after 1 March 2020. After 1 March 2020, substantial and sustained reductions in hospital admissions were found for all but one of the 19 infective conditions studied. Among the respiratory infections, the greatest percentage reductions were for influenza (mean annual number admitted between 1 March 2017 and 29 February 2020 was 5379 and number of children admitted from 1 March 2020 to 28 February 2021 was 304, 94% reduction, 95% confidence interval 89% to 97%), and bronchiolitis (from 51 655 to 9423, 82% reduction, 95% confidence interval 79% to 84%). Among the severe invasive infections, the greatest reduction was for meningitis (50% reduction, 47% to 52%). For the vaccine preventable infections, reductions ranged from 53% (32% to 68%) for mumps to 90% (80% to 95%) for measles. Reductions were seen across all demographic subgroups and in children with underlying comorbidities. Corresponding decreases were also found for the absolute numbers of 60 day case fatalities, although the proportion of children admitted for pneumonia who died within 60 days increased (age-sex adjusted odds ratio 1.71, 95% confidence interval 1.43 to 2.05). More recent data indicate that some respiratory infections increased to higher levels than usual after May 2021. During the covid-19 pandemic, a range of behavioural changes (adoption of non-pharmacological interventions) and societal strategies (school closures, lockdowns, and restricted travel) were used to reduce transmission of SARS-CoV-2, which also reduced admissions for common and severe childhood infections. Continued monitoring of these infections is required as social restrictions evolve.
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影响因子：
9.4
作者：
Brunstein, John D.;Cline, Christy L.;Thomas, Eva
通讯作者：
Thomas, Eva
影响因子：
5.2
作者：
Vasquez-Hoyos, Pablo;Diaz-Rubio, Franco;Gonzalez-Dambrauskas, Sebastian
通讯作者：
Gonzalez-Dambrauskas, Sebastian
影响因子：
36.4
作者：
Goetzinger, Florian;Santiago-Garcia, Begona;Tebruegge, Marc
通讯作者：
Tebruegge, Marc
影响因子：
3.6
作者：
Hensey, Conor C.;Sett, Arun;Bryant, Penelope A.
通讯作者：
Bryant, Penelope A.
影响因子：
3.7
作者：
Jackson C;Mangtani P;Hawker J;Olowokure B;Vynnycky E
通讯作者：
Vynnycky E