Investigation and analysis of children's behavior and outpatient number of respiratory diseases in Shanghai before and after the COVID-19 pandemic

Abstract

Objective: Alterations in behavioral habits of children were analyzed in Shanghai in the winters prior to and following the COVID-19 pandemic, with the aim of assisting in the prevention of children's respiratory diseases in the post-pandemic era.

Method: This cross-sectional survey was conducted via an offline questionnaire from January 1 to February 28, 2021. The behavioral habits of Shanghainese children in different age groups during the winter of 2019 and 2020 were statistically analyzed using the SPSS 25.0 software. The parameters surveyed and analyzed included the frequency of outdoor activities, self-protection measures (frequency of wearing masks and washing hands after going out), travel history, time to visit since symptom onset, and influenza vaccination status. Lastly, the number of cases of respiratory diseases in the pediatric outpatient department of our hospital was analyzed during the same period.

Result: A total of 1816 questionnaires were investigated and analyzed, and the results revealed that self-protection measures were significantly enhanced in children of all age groups after the COVID-19 pandemic breakout compared with those before the pandemic, whereas the frequency of outdoor activities and traveling were reduced. In the age group over 3 years old, the time to visit since symptom onset was shorter, and the influenza vaccination rate increased following the pandemic. During the same period, the number of cases of children with respiratory diseases in our outpatient department was significantly decreased compared with that prior to the COVID-19 pandemic.

Conclusion: The COVID-19 pandemic has had a significant impact on self-protection measures, outdoor activities, and other children's behaviors in all age groups in Shanghai. These changes in habits were correlated with a lower incidence and transmission of respiratory diseases in children. Overall, this study lays a theoretical basis for the prevention of childhood illnesses in the post-pandemic era.

Keywords: Behavioral habits; COVID-19; Children; Cross-sectional survey.

Fig. 1

Gender distribution of children in different age groups (The abscissa in the figure represents different age groups, the ordinate represents the number of people, the blue represents the total number of males and females, the orange represents the number of males, and the gray represents the number of females.).

Fig. 2

The statistics and analysis of changes in behavior habits of children in Shanghai before and after the COVID-19 (All abscissas in the figure represent all age groups (adjacent histograms represent the differences between the same groups before and after the epidemic), and the ordinate represents the percentage of different behavior habits among groups. The meanings of different colors in each figure are as follows: A: Blue means the frequency of wearing masks outdoors 0–3 times/week, orange means the frequency of wearing masks outdoors 4–6 times/week, and gray means the frequency of wearing masks outdoors≥7 times/week. B：Blue means the time of first hospital visit<12 h，orange means the time of first hospital visit 12–24 h，gray means the time of first hospital visit 24–48 h，yellow means the time of first hospital visit>48 h. C：Blue means the frequency of washing hands 0–3 times/week，orange means the frequency of washing hands 4–6 times/week，gray means the frequency of washing hands≥7 times/week. D：Blue means the frequency of outdoor activities 0–3 times/week，orange means the frequency of outdoor activities 4–6 times/week，gray means the frequency of outdoor activities≥7 times/week. E：Blue means the inoculate influenza vaccination，orange means didn't inoculate influenza vaccination. F：Blue means don't take domestic tourism，orange means take domestic tourism. G：Blue means the frequency of taking public transport 0–3 times/week，orange means the frequency of taking public transport 4–6 times/week，gray means the frequency of taking public transport≥7 times/week. H：Blue means don't take overseas tourism，orange means take overseas tourism.).

Fig. 2

The statistics and analysis of changes in behavior habits of children in Shanghai before and after the COVID-19 (All abscissas in the figure represent all age groups (adjacent histograms represent the differences between the same groups before and after the epidemic), and the ordinate represents the percentage of different behavior habits among groups. The meanings of different colors in each figure are as follows: A: Blue means the frequency of wearing masks outdoors 0–3 times/week, orange means the frequency of wearing masks outdoors 4–6 times/week, and gray means the frequency of wearing masks outdoors≥7 times/week. B：Blue means the time of first hospital visit<12 h，orange means the time of first hospital visit 12–24 h，gray means the time of first hospital visit 24–48 h，yellow means the time of first hospital visit>48 h. C：Blue means the frequency of washing hands 0–3 times/week，orange means the frequency of washing hands 4–6 times/week，gray means the frequency of washing hands≥7 times/week. D：Blue means the frequency of outdoor activities 0–3 times/week，orange means the frequency of outdoor activities 4–6 times/week，gray means the frequency of outdoor activities≥7 times/week. E：Blue means the inoculate influenza vaccination，orange means didn't inoculate influenza vaccination. F：Blue means don't take domestic tourism，orange means take domestic tourism. G：Blue means the frequency of taking public transport 0–3 times/week，orange means the frequency of taking public transport 4–6 times/week，gray means the frequency of taking public transport≥7 times/week. H：Blue means don't take overseas tourism，orange means take overseas tourism.).

Fig. 3

The numbers of children in different age groups with respiratory diseases in the pediatric outpatient department in the winter of 2019 and 2020 (In the figure, the abscissa represents the number of patients, and the ordinate represents the distribution of different age groups. Blue represents the winter of 2019 and orange represents the winter of 2020.).