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Front Pediatr . Shift in Clinical Profile of Hospitalized Pneumonia in Children in the Non-pharmaceutical Interventions Period During the COVID-19 P

tetano

Editor, Senior Moderator
Front Pediatr


. 2022 Mar 22;10:782894.
doi: 10.3389/fped.2022.782894. eCollection 2022.
Shift in Clinical Profile of Hospitalized Pneumonia in Children in the Non-pharmaceutical Interventions Period During the COVID-19 Pandemic: A Prospective Multicenter Study


Alexis Rybak[SUP] 1 2 3 [/SUP], Naïm Ouldali[SUP] 1 3 4 [/SUP], François Angoulvant[SUP] 4 5 6 [/SUP], Philippe Minodier[SUP] 6 7 [/SUP], Sandra Biscardi[SUP] 6 8 [/SUP], Fouad Madhi[SUP] 6 9 [/SUP], Isabelle Hau[SUP] 6 9 [/SUP], Audrey Santos[SUP] 2 [/SUP], Emilie Bouvy[SUP] 6 10 [/SUP], François Dubos[SUP] 6 10 [/SUP], Alain Martinot[SUP] 6 10 [/SUP], Marie-Aliette Dommergues[SUP] 6 11 [/SUP], Christèle Gras-Le Guen[SUP] 6 12 [/SUP], Elise Launay[SUP] 6 12 [/SUP], Karine Levieux[SUP] 6 12 [/SUP], Ferielle Zenkhri[SUP] 6 13 [/SUP], Irina Craiu[SUP] 6 13 [/SUP], Mathie Lorrot[SUP] 6 14 [/SUP], Yves Gillet[SUP] 6 15 [/SUP], Ellia Mezgueldi[SUP] 6 15 [/SUP], Albert Faye[SUP] 3 4 6 [/SUP], Stéphane Béchet[SUP] 1 6 [/SUP], Emmanuelle Varon[SUP] 6 16 [/SUP], Robert Cohen[SUP] 1 6 17 18 19 [/SUP], Corinne Levy[SUP] 1 6 17 18 [/SUP]



Affiliations

Abstract

Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 were implemented in March 2020. These measures were followed by a major impact on viral and non-viral diseases. We aimed to assess the impact of NPI implementation in France on hospitalized community-acquired pneumonia (hCAP) frequency and the clinical and biological characteristics of the remaining cases in children. We performed a quasi-experimental interrupted time-series analysis. Between June 2014 and December 2020, eight pediatric emergency departments throughout France reported prospectively all cases of hCAP in children from age 1 month to 15 years. We estimated the impact on the monthly number of hCAP using segmented linear regression with autoregressive error model. We included 2,972 hCAP cases; 115 occurred during the NPI implementation period. We observed a sharp decrease in the monthly number of hCAP after NPI implementation [-63.0% (95 confidence interval, -86.8 to -39.2%); p < 0.001]. Children with hCAP were significantly older during than before the NPI period (median age, 3.9 vs. 2.3 years; p < 0.0001), and we observed a higher proportion of low inflammatory marker status (43.5 vs. 33.1%; p = 0.02). Furthermore, we observed a trend with a decrease in the proportion of cases with pleural effusion (5.3% during the NPI period vs. 10.9% before the NPI; p = 0.06). NPI implementation during the COVID-19 (coronavirus disease 2019) pandemic led not only to a strong decrease in the number of hCAP cases but also a modification in the clinical profile of children affected, which may reflect a change in pathogens involved.

Keywords: COVID-19; children; community-acquired pneumonia; non-pharmaceutical intervention; time series analysis.
 
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