Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China: A nationwide retrospective study

Abstract

Epstein-Barr virus (EBV) is very common, with the infection rate in adults over 90% worldwide. Infectious mononucleosis (IM) is caused by primary infection with EBV. Most IM patients are generally considered to have a favorable prognosis, but a few patients will also develop complications. Children with severe symptoms will require hospitalization. However, the disease burden of children hospitalized with IM in China has been rarely described. In this study, we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st, 2016 to Dec 31st, 2020, and medical information such as gender, age, region, time of admission, length of stay and expenditure were extracted. There were 24,120 IM cases, which accounted for 0.42% (24,120/5,693,262) of all hospitalized cases during this period. The ratio of male to female was 1.48:1. Hospitalization for IM in the 4-6 ​years age group was the highest among inpatients of all age groups. Case numbers increased year by year between 2016 and 2020, and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year. Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients. The median length of stay was 8 days, and the median cost of hospitalization was 970.59 US dollars. This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.

Keywords: Children; Disease burden; Epidemiological characteristics; Epstein-Barr virus (EBV); Infectious mononucleosis (IM).

Fig. 1

Gender proportion of hospitalized children with IM in different areas (A), age groups (B), years of admission (C), and residence (D).

Fig. 2

The ratio of IM hospitalizations to total hospitalizations in different regions of China (A), age groups (B), years (C), and residence (D). Statistical analyses were performed using the chi-square test or Fisher exact test. A P-value < 0.05 was considered statistically significant.

Fig. 3

Monthly cases of children hospitalized for IM from Jan 1st, 2016, to Dec 31st, 2020.

Fig. 4

Distribution of complications in children hospitalized for IM (n ​= ​24,120).

Fig. 5

LOS and expenses of different complications. A The LOS of different complications; B The expenses of different complications.