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. 2022 Nov:22:100497.
doi: 10.1016/j.lanepe.2022.100497. Epub 2022 Aug 23.

Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France

Pr Robert Cohen  1   2   3   4   5 , Alexis Rybak  1   4   6   7 , Andreas Werner  4 , Stéphane Béchet  1   4   5 , Roxane Desandes  4 , Fréderic Hassid  4 , Jean-Marie André  4 , Nathalie Gelbert  4 , Georges Thiebault  4 , Fabienne Kochert  4 , Fabienne Cahn-Sellem  4 , François Vié Le Sage  4 , Pr François Angoulvant  7   8   9 , Naïm Ouldali  1   6   7   10 , Bruno Frandji  11 , Corinne Levy  1   2   3   4   5
Affiliations

Trends in pediatric ambulatory community acquired infections before and during COVID-19 pandemic: A prospective multicentric surveillance study in France

Pr Robert Cohen et al. Lancet Reg Health Eur. 2022 Nov.

Abstract

Background: Covid-19 pandemic control has imposed several non-pharmaceutical interventions (NPIs). Strict application of these measures has had a dramatic reduction on the epidemiology of several infectious diseases. As the pandemic is ongoing for more than 2 years, some of these measures have been removed, mitigated, or less well applied. The aim of this study is to investigate the trends of pediatric ambulatory infectious diseases before and up to two years after the onset of the pandemic.

Methods: We conducted a prospective surveillance study in France with 107 pediatricians specifically trained in pediatric infectious diseases. From January 2018 to April 2022, the electronic medical records of children with an infectious disease were automatically extracted. The annual number of infectious diseases in 2020 and 2021 was compared to 2018-2019 and their frequency was compared by logistic regression.

Findings: From 2018 to 2021, 185,368 infectious diseases were recorded. Compared to 2018 (n=47,116) and 2019 (n=51,667), the annual number of cases decreased in 2020 (n=35,432) by about a third. Frequency of scarlet fever, tonsillopharyngitis, enteroviral infections, bronchiolitis, and gastroenteritis decreased with OR varying from 0·6 (CI95% [0·5;0·7]) to 0·9 (CI95% [0·8;0·9]), p<0·001. In 2021, among the 52,153 infectious diagnoses, an off-season rebound was observed with increased frequency of enteroviral infections, bronchiolitis, gastroenteritis and otitis with OR varying from 1·1 (CI95% [1·0;1·1]) to 1·5 (CI95% [1·4;1·5]), p<0·001.

Interpretation: While during NPIs strict application, the overall frequency of community-acquired infections was reduced, after relaxation of these measures, a rebound of some of them (enteroviral infections, bronchiolitis, gastroenteritis, otitis) occurred beyond the pre-pandemic level. These findings highlight the need for continuous surveillance of infectious diseases, especially insofar as future epidemics are largely unpredictable.

Funding: ACTIV, AFPA, GSK, MSD, Pfizer and Sanofi.

Keywords: Ambulatory network; Children; Covid-19 pandemic; Immunity debt.

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Conflict of interest statement

RC reports grants to the institution ACTIV, personal fees, and nonfinancial support from GSK, Sanofi, Pfizer, and Merck, outside the submitted work. AR reports travel grants from Pfizer and AstraZeneca. FA reports receiving personal fees from MSD, AstraZeneca, Sanofi and Pfizer.NO reports travel grants from Pfizer, Sanofi, and GSK, outside the submitted work. BF is employed by CompuGroup Medical. CL reports grants to the institution ACTIV from GSK, Sanofi, Pfizer, and Merck, and personal fees and nonfinancial support from Pfizer and Merck, outside the conduct of the study. All other authors report no potential conflicts.

Figures

Figure 1
Figure 1
Bi-weekly number of enteroviral infections, bronchiolitis, gastroenteritis, and otitis between January 2018 and April 2022 in children included in the Pediatric and Ambulatory Research in Infectious surveillance network. The lockdowns during the study period are shown in purple for 2020 and in yellow for 2021.
Figure 2
Figure 2
Bi-weekly number of overall cases of tonsillopharyngitis and pharyngitis, group A Streptococcal (GAS) tonsillopharyngitis and pharyngitis, scarlet fever, influenza-like illness, chickenpox, and pneumonia between January 2018 and April 2022 in children included in the Pediatric and Ambulatory Research in Infectious surveillance network. The lockdowns during the study period are shown in purple for 2020 and in yellow for 2021.
Figure 3
Figure 3
Monthly number of bronchiolitis, influenza-like illness and otitis cases between January 2018 and April 2022 in children included in the Pediatric and Ambulatory Research in Infectious surveillance network.
See this image and copyright information in PMC

Comment in

References

    1. Baker RE, Park SW, Yang W, Vecchi GA, Metcalf CJE, Grenfell BT. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections. Proc Natl Acad Sci USA. 2020;117(48):30547–30553. - PMC - PubMed
    1. Belingheri M, Paladino ME, Piacenti S, Riva MA. Effects of COVID-19 lockdown on epidemic diseases of childhood. J Med Virol. 2021;93(1):153–154. - PMC - PubMed
    1. Brueggemann AB, Jansen van Rensburg MJ, Shaw D, et al. Changes in the incidence of invasive disease due to streptococcus pneumoniae, haemophilus influenzae, and neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the invasive respiratory infection surveillance initiative: a prospective analysis of surveillance data. Lancet Digit Health. 2021;3(6):e360–e370. - PMC - PubMed
    1. Taha MK, Deghmane AE. Impact of COVID-19 pandemic and the lockdown on invasive meningococcal disease. BMC Res Notes. 2020;13(1):399. - PMC - PubMed
    1. Yeoh DK, Foley DA, Minney-Smith CA, et al. The impact of COVID-19 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 Australian winter. Clin Infect Dis. 2021;72(12):2199–2202. doi: 10.1093/cid/ciaa1475. - DOI - PMC - PubMed