1
|
Klee B, Diexer S, Horn J, Langer S, Wende M, Ortiz D, Bielecka A, Strowig T, Mikolajczyk R, Gottschick C. The impact of non-pharmaceutical interventions on community non-SARS-CoV-2 respiratory infections in preschool children. BMC Pediatr 2024; 24:231. [PMID: 38561704 PMCID: PMC10985994 DOI: 10.1186/s12887-024-04686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/02/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effects of non-pharmaceutical interventions during the pandemic were mainly studied for severe outcomes. Among children, most of the burden of respiratory infections is related to infections which are not medically attended. The perspective on infections in the community setting is necessary to understand the effects of the pandemic on non-pharmaceutical interventions. METHODS In the unique prospective LoewenKIDS cohort study, we compared the true monthly incidence of self-reported acute respiratory infections (ARI) in about 350 participants (aged 3-4 years old) between October 2019 to March 2020 (pre-pandemic period) and October 2020 to March 2021 (pandemic period). Parents reported children's symptoms using a diary. Parents were asked to take a nasal swab of their child during all respiratory symptoms. We analysed 718 swabs using Multiplex PCR for 25 common respiratory viruses and bacteria. RESULTS During the pre-pandemic period, on average 44.6% (95% CI: 39.5-49.8%) of children acquired at least one ARI per month compared to 19.9% (95% CI: 11.1-28.7%) during the pandemic period (Incidence Rate Ratio = 0.47; 95% CI: 0.41-0.54). The detection of influenza virus decreased absolute by 96%, respiratory syncytial virus by 65%, metapneumovirus by 95%, parainfluenza virus by 100%, human enterovirus by 96% and human bocavirus by 70% when comparing the pre-pandemic to the pandemic period. However, rhinoviruses were nearly unaffected by NPI. Co-detection (detection of more than one virus in a single symptomatic swab) was common in the pre-pandemic period (222 of 390 samples with viral detection; 56.9%) and substantially less common during the pandemic period (46 of 216 samples; 21.3%). CONCLUSION Non-pharmaceutical interventions strongly reduced the incidence of all respiratory infections in preschool children but did not affect rhinovirus.
Collapse
Affiliation(s)
- Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sophie Diexer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Johannes Horn
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Susan Langer
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Marie Wende
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
| | - Diego Ortiz
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Agata Bielecka
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Till Strowig
- Helmholtz Centre for Infection Research, Braunschweig, Germany
- German Centre for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
- Hannover Medical School, Cluster of Excellence RESIST (EXC 2155), Hannover, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| |
Collapse
|
2
|
Matera L, Manti S, Petrarca L, Pierangeli A, Conti MG, Mancino E, Leonardi S, Midulla F, Nenna R. An overview on viral interference during SARS-CoV-2 pandemic. Front Pediatr 2023; 11:1308105. [PMID: 38178911 PMCID: PMC10764478 DOI: 10.3389/fped.2023.1308105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
Respiratory viruses represent the most frequent cause of mortality, morbidity and high healthcare costs for emergency visits and hospitalization in the pediatric age. Respiratory viruses can circulate simultaneously and can potentially infect the same host, determining different types of interactions, the so-called viral interference. The role of viral interference has assumed great importance since December 2019, when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) came on the scene. The aim of this narrative review is to present our perspective regarding research in respiratory virus interference and discuss recent advances on the topic because, following SARS-CoV-2 restrictions mitigation, we are experimenting the co-circulation of respiratory viruses along with SARS-CoV-2. This scenario is raising many concerns about possible virus-virus interactions, both positive and negative, and the clinical, diagnostic and therapeutic management of these coinfections. Moreover, we cannot rule out that also climatic conditions and social behaviours are involved. Thus, this situation can lead to different population epidemic dynamics, including changes in the age of the targeted population, disease course and severity, highlighting the need for prospective epidemiologic studies and mathematical modelling able to predict the timing and magnitude of epidemics caused by SARS-CoV-2/seasonal respiratory virus interactions in order to adjust better public health interventions.
Collapse
Affiliation(s)
- Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Sara Manti
- Department of Human and Pediatric Pathology, Pediatric Unit, G. Martino Hospital, University of Messina, Messina, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandra Pierangeli
- Laboratory of Virology, Department of Molecular Medicine, Affiliated to Istituto Pasteur Italia, Sapienza University of Rome, Rome, Italy
| | - Maria Giulia Conti
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Salvatore Leonardi
- Pediatric Respiratory Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
3
|
Peri F, Lorenzon B, Cason C, Amaddeo A, Norbedo S, Comar M, Barbi E, Cozzi G. Urgent Hospitalizations Related to Viral Respiratory Disease in Children during Autumn and Winter Seasons 2022/2023. Viruses 2023; 15:2425. [PMID: 38140665 PMCID: PMC10748011 DOI: 10.3390/v15122425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
AIM The loosening of social distancing measures over the past two years has led to a resurgence of seasonal epidemics associated with respiratory viral infections in children. We aim to describe the impact of such infections through urgent hospitalizations in a pediatric emergency department. METHODS We performed a retrospective review of medical records of all children and adolescents with a positive nasal swab admitted at the children's hospital IRCCS Burlo Garofolo of Trieste, in Italy, from September 2021 to March 2022, and September 2022 to March 2023. RESULTS Respiratory Syncytial Virus and Influenza viruses accounted for up to 55% of hospitalizations for respiratory infections during the study periods. During the last season, the number of hospitalizations related to the Influenza virus was five times higher than those related to SARS-CoV-2 (25% vs. 5%). Respiratory Syncytial Virus was associated with a greater need for respiratory support, mostly HFNC (High Flow Nasal Cannula). CONCLUSIONS Respiratory Syncytial Virus and Influenza virus had a more significant impact on urgent hospitalizations during the past wintery seasons than SARS-CoV-2.
Collapse
Affiliation(s)
- Francesca Peri
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy; (B.L.); (E.B.)
| | - Beatrice Lorenzon
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy; (B.L.); (E.B.)
| | - Carolina Cason
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34100 Trieste, Italy; (C.C.); (M.C.)
| | - Alessandro Amaddeo
- Emergency Department, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34100 Trieste, Italy; (A.A.); (S.N.); (G.C.)
| | - Stefania Norbedo
- Emergency Department, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34100 Trieste, Italy; (A.A.); (S.N.); (G.C.)
| | - Manola Comar
- SSD of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34100 Trieste, Italy; (C.C.); (M.C.)
- Department of Medical Sciences, University of Trieste, Piazzale Europa 1, 34127 Trieste, Italy
| | - Egidio Barbi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34100 Trieste, Italy; (B.L.); (E.B.)
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS “Burlo Garofolo”, 34100 Trieste, Italy
| | - Giorgio Cozzi
- Emergency Department, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34100 Trieste, Italy; (A.A.); (S.N.); (G.C.)
| |
Collapse
|
4
|
Cozzi G, Sovtic A, Garelli D, Krivec U, Silvagni D, Corsini I, Colombo M, Giangreco M, Giannattasio A, Milani GP, Minute M, Marchetti F, Gatto A, Debbia C, Gortan AJ, Massaro M, Hatziagorou E, Ravidà D, Diamand R, Jones E, Visekruna J, Zago A, Barbi E, Amaddeo A, Cortellazzo Wiel L. SARS-CoV-2-related bronchiolitis: a multicentre international study. Arch Dis Child 2023; 108:e15. [PMID: 37130726 DOI: 10.1136/archdischild-2023-325448] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited. OBJECTIVE To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses. SETTING, PATIENTS, INTERVENTIONS A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected. MAIN OUTCOME MEASURES The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative. RESULTS 2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85). CONCLUSIONS SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course.
Collapse
Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Aleksandar Sovtic
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
- University of Belgrade Faculty of Medicine, Beograd, Serbia
| | | | - Uros Krivec
- Department of Pediatric Pulmology, University Children's Hospital Ljubljana, Ljubljana, Slovenia
- Department of Pediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Davide Silvagni
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Ilaria Corsini
- IRCCS Policlinico Ospedaliero Universitario di Bologna, Bologna, Italy
| | - Marco Colombo
- Pediatric Emergency Deparment, Ospedale Filippo del Ponte, ASST Sette Laghi, Varese, Italy
| | - Manuela Giangreco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | | | - Gregorio Paolo Milani
- Paediatric Emergency Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
| | - Marta Minute
- Ospedale Regionale Ca Foncello Treviso, Treviso, Italy
| | | | - Antonio Gatto
- Department of Pediatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Carla Debbia
- Emergency Departement, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | | | - Marta Massaro
- Ospedale Santa Maria degli Angeli di Pordenone, Pordenone, Italy
| | - Elpis Hatziagorou
- Pediatric Pulmonology Unit, 3rd Pediatric Dept, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Domenico Ravidà
- Institute of Pediatrics of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Raz Diamand
- Ruth Rappaport Children's Hospital, Haifa, Israel
| | | | - Jelena Visekruna
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
| | | | - Egidio Barbi
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | | |
Collapse
|
5
|
Gil E, Roy S, Best T, Hatcher J, Breuer J. Increasing rhinovirus prevalence in paediatric intensive care patients since the SARS-CoV2 pandemic. J Clin Virol 2023; 166:105555. [PMID: 37536014 DOI: 10.1016/j.jcv.2023.105555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Rhinovirus (HRV) is a significant seasonal pathogen in children. The emergence of SARS-CoV2, and the social restrictions introduced in, disrupted viral epidemiology. Here we describe the experience of Great Ormond Street Hospital (GOSH), where HRV almost entirely disappeared from the paediatric intensive care units (PICU) during the first national lockdown and then rapidly re-emerged with a fast-increasing incidence, leading to concerns about possible nosocomial transmission in a vulnerable population. OBJECTIVES To describe alterations in HRV infection amongst PICU patients at GOSH since the emergence of SARS-COV2 STUDY DESIGN: 10,950 nasopharyngeal aspirate viral PCR samples from GOSH PICU patients from 2019 to 2023 were included. 3083 returned a positive result for a respiratory virus, with 1530 samples positive for HRV. 66 HRV isolates from August 2020 - Jan 2021, the period of rapidly increasing HRV incidence, were sequenced. Electronic health record data was retrospectively collected for the same period. RESULTS Following a reduction in the incidence of HRV infection during the first national lockdown, multiple genotypes of HRV emerged amongst GOSH PICU patients, with the incidence of HRV infection rapidly surging to levels higher than that seen prior to the emergence of SARS-CoV2 and continuing to circulate at increased incidence year-round. CONCLUSIONS The incidence of HRV infection amongst GOSH PICU patients is markedly higher than prior to the emergence of SARS-CoV2, a pattern not seen in other respiratory viruses. The increased burden of HRV-infection in vulnerable PICU patients has both clinical and infection prevention and control Implications.
Collapse
Affiliation(s)
- Eliza Gil
- Department of Clinical Research, London School of Hygiene and Tropical Medicine; Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK.
| | - Sunando Roy
- Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
| | - Tim Best
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - James Hatcher
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK
| | - Judith Breuer
- Department of Microbiology, Virology & Infection Control, Great Ormond Street Hospital for Children, UK; Infection, Immunity and Inflammation Department, GOS Institute of Child Health, University College London, London, UK
| |
Collapse
|
6
|
Rankin DA, Spieker AJ, Perez A, Stahl AL, Rahman HK, Stewart LS, Schuster JE, Lively JY, Haddadin Z, Probst V, Michaels MG, Williams JV, Boom JA, Sahni LC, Staat MA, Schlaudecker EP, McNeal MM, Harrison CJ, Weinberg GA, Szilagyi PG, Englund JA, Klein EJ, Gerber SI, McMorrow M, Rha B, Chappell JD, Selvarangan R, Midgley CM, Halasa NB. Circulation of Rhinoviruses and/or Enteroviruses in Pediatric Patients With Acute Respiratory Illness Before and During the COVID-19 Pandemic in the US. JAMA Netw Open 2023; 6:e2254909. [PMID: 36749589 PMCID: PMC10408278 DOI: 10.1001/jamanetworkopen.2022.54909] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/19/2022] [Indexed: 02/08/2023] Open
Abstract
IMPORTANCE Rhinoviruses and/or enteroviruses, which continued to circulate during the COVID-19 pandemic, are commonly detected in pediatric patients with acute respiratory illness (ARI). Yet detailed characterization of rhinovirus and/or enterovirus detection over time is limited, especially by age group and health care setting. OBJECTIVE To quantify and characterize rhinovirus and/or enterovirus detection before and during the COVID-19 pandemic among children and adolescents seeking medical care for ARI at emergency departments (EDs) or hospitals. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the New Vaccine Surveillance Network (NVSN), a multicenter, active, prospective surveillance platform, for pediatric patients who sought medical care for fever and/or respiratory symptoms at 7 EDs or hospitals within NVSN across the US between December 2016 and February 2021. Persons younger than 18 years were enrolled in NVSN, and respiratory specimens were collected and tested for multiple viruses. MAIN OUTCOMES AND MEASURES Proportion of patients in whom rhinovirus and/or enterovirus, or another virus, was detected by calendar month and by prepandemic (December 1, 2016, to March 11, 2020) or pandemic (March 12, 2020, to February 28, 2021) periods. Month-specific adjusted odds ratios (aORs) for rhinovirus and/or enterovirus-positive test results (among all tested) by setting (ED or inpatient) and age group (<2, 2-4, or 5-17 years) were calculated, comparing each month during the pandemic to equivalent months of previous years. RESULTS Of the 38 198 children and adolescents who were enrolled and tested, 11 303 (29.6%; mean [SD] age, 2.8 [3.7] years; 6733 boys [59.6%]) had rhinovirus and/or enterovirus-positive test results. In prepandemic and pandemic periods, rhinoviruses and/or enteroviruses were detected in 29.4% (9795 of 33 317) and 30.9% (1508 of 4881) of all patients who were enrolled and tested and in 42.2% (9795 of 23 236) and 73.0% (1508 of 2066) of those with test positivity for any virus, respectively. Rhinoviruses and/or enteroviruses were the most frequently detected viruses in both periods and all age groups in the ED and inpatient setting. From April to September 2020 (pandemic period), rhinoviruses and/or enteroviruses were detectable at similar or lower odds than in prepandemic years, with aORs ranging from 0.08 (95% CI, 0.04-0.19) to 0.76 (95% CI, 0.55-1.05) in the ED and 0.04 (95% CI, 0.01-0.11) to 0.71 (95% CI, 0.47-1.07) in the inpatient setting. However, unlike some other viruses, rhinoviruses and/or enteroviruses soon returned to prepandemic levels and from October 2020 to February 2021 were detected at similar or higher odds than in prepandemic months in both settings, with aORs ranging from 1.47 (95% CI, 1.12-1.93) to 3.01 (95% CI, 2.30-3.94) in the ED and 1.36 (95% CI, 1.03-1.79) to 2.44 (95% CI, 1.78-3.34) in the inpatient setting, and in all age groups. Compared with prepandemic years, during the pandemic, rhinoviruses and/or enteroviruses were detected in patients who were slightly older, although most (74.5% [1124 of 1508]) were younger than 5 years. CONCLUSIONS AND RELEVANCE Results of this study show that rhinoviruses and/or enteroviruses persisted and were the most common respiratory virus group detected across all pediatric age groups and in both ED and inpatient settings. Rhinoviruses and/or enteroviruses remain a leading factor in ARI health care burden, and active ARI surveillance in children and adolescents remains critical for defining the health care burden of respiratory viruses.
Collapse
Affiliation(s)
- Danielle A. Rankin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Epidemiology PhD Program, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Andrew J. Spieker
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ariana Perez
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- General Dynamics Information Technology Inc, Falls Church, Virginia
| | - Anna L. Stahl
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Herdi K. Rahman
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Laura S. Stewart
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Joana Y. Lively
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zaid Haddadin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Varvara Probst
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Marian G. Michaels
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - John V. Williams
- Department of Pediatrics, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julie A. Boom
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Leila C. Sahni
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston
| | - Mary A. Staat
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Elizabeth P. Schlaudecker
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Monica M. McNeal
- Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Christopher J. Harrison
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Geoffrey A. Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Peter G. Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
- Department of Pediatrics, UCLA (University of California, Los Angeles) Mattel Children’s Hospital, UCLA, Los Angeles
| | - Janet A. Englund
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Eileen J. Klein
- Seattle Children’s Hospital, Department of Pediatrics, University of Washington School of Medicine, Seattle
| | - Susan I. Gerber
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meredith McMorrow
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James D. Chappell
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rangaraj Selvarangan
- Division of Pediatric Infectious Diseases, Children’s Mercy Kansas City, Kansas City, Missouri
- Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, Kansas City, Missouri
| | - Claire M. Midgley
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natasha B. Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | | |
Collapse
|
7
|
Alaniz AJ, Carvajal MA, Carvajal JG, Vergara PM. Effects of air pollution and weather on the initial COVID-19 outbreaks in United States, Italy, Spain, and China: A comparative study. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2023; 43:8-18. [PMID: 36509703 PMCID: PMC9877606 DOI: 10.1111/risa.14080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/03/2022] [Accepted: 11/05/2022] [Indexed: 06/17/2023]
Abstract
Contrasting effects have been identified in association of weather (temperature and humidity) and pollutant gases with COVID-19 infection, which could be derived from the influence of lockdowns and season change. The influence of pollutant gases and climate during the initial phases of the pandemic, before the closures and the change of season in the northern hemisphere, is unknown. Here, we used a spatial-temporal Bayesian zero-inflated-Poisson model to test for short-term associations of weather and pollutant gases with the relative risk of COVID-19 disease in China (first outbreak) and the countries with more cases during the initial pandemic (the United States, Spain and Italy), considering also the effects of season and lockdown. We found contrasting association between pollutant gases and COVID-19 risk in the United States, Italy, and Spain, while in China it was negatively associated (except for SO2 ). COVID-19 risk was positively associated with specific humidity in all countries, while temperature presented a negative effect. Our findings showed that short-term associations of air pollutants with COVID-19 infection vary strongly between countries, while generalized effects of temperature (negative) and humidity (positive) with COVID-19 was found. Our results show novel information about the influence of pollution and weather on the initial outbreaks, which contribute to unravel the mechanisms during the beginning of the pandemic.
Collapse
Affiliation(s)
- Alberto J. Alaniz
- Departamento de Ingeniería Geoespacial y Ambiental, Facultad de IngenieríaUniversidad de Santiago de ChileSantiagoChile
- Facultad de Ciencias BiológicasPontificia Universidad Católica de ChileSantiagoChile
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
- Centro de Estudios en Ecología Espacial y Medio AmbienteEcogeografíaSantiagoChile
| | - Mario A. Carvajal
- Facultad de Ciencias BiológicasPontificia Universidad Católica de ChileSantiagoChile
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
| | - Jorge G. Carvajal
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
- Centro de Estudios en Ecología Espacial y Medio AmbienteEcogeografíaSantiagoChile
| | - Pablo M. Vergara
- Departamento de Gestión Agraria, Facultad TecnológicaUniversidad de Santiago de ChileSantiagoChile
| |
Collapse
|
8
|
Servidio AG, Visentin G, Conti R, Cozzi G, Travan L, Bua J, Barbi E, Amaddeo A. Mild COVID-19 in hospitalised infants younger than 90 days. Acta Paediatr 2022; 112:483-485. [PMID: 36513613 PMCID: PMC9878078 DOI: 10.1111/apa.16624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/15/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Affiliation(s)
| | - Giacomo Visentin
- Department of Medicine, Surgery, and Health SciencesUniversity of TriesteTriesteItaly
| | - Rosaura Conti
- Department of Medicine, Surgery, and Health SciencesUniversity of TriesteTriesteItaly
| | - Giorgio Cozzi
- Institute for Maternal and Child HealthIRCCS Burlo GarofoloTriesteItaly
| | - Laura Travan
- Institute for Maternal and Child HealthIRCCS Burlo GarofoloTriesteItaly
| | - Jenny Bua
- Institute for Maternal and Child HealthIRCCS Burlo GarofoloTriesteItaly
| | - Egidio Barbi
- Department of Medicine, Surgery, and Health SciencesUniversity of TriesteTriesteItaly,Institute for Maternal and Child HealthIRCCS Burlo GarofoloTriesteItaly
| | | |
Collapse
|
9
|
Changing Epidemiology of Acute Viral Respiratory Infections in Hospitalized Children: The Post-Lockdown Effect. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081242. [PMID: 36010132 PMCID: PMC9406795 DOI: 10.3390/children9081242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 11/21/2022]
Abstract
Several reports highlighted how public health measures aimed at limiting severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) circulation have likely contributed to reducing the circulation of other respiratory viruses, particularly during the first year of the COVID-19 pandemic. We evaluated the epidemiology of acute respiratory infections in a large cohort of hospitalized children during the third year of the pandemic (2021−2022). We retrospectively analyzed data from the health records of children (<14 years) hospitalized for acute respiratory infections between 1 July 2021 and 31 March 2022. A total of 1763 respiratory panels were collected. Overall, 1269 (72%) panels hadpositive results for at least one pathogen. Most positive panels (53.8%) belonged to patients aged 1−12 months. The most detected pathogen was respiratory syncytial virus (RSV) (57.8% of positive panels). The RSV peak occurred in November 2021. Nine hundred and forty-five (74.5%) panels were positive for one pathogen while three hundred and twenty-four (25.5%) showed multiple infections. Patients with multiple infections were significantly older than those with a single infection. The 2021−2022 peak of RSV infection in Italy occurred earlier than in the previous pre-pandemic seasons. A high number of children have been hospitalized because of acute viral infections also due to less aggressive viruses.
Collapse
|
10
|
Cozzi G, Cortellazzo Wiel L, Amaddeo A, Gatto A, Giangreco M, Klein-Kremer A, Bosis S, Silvagni D, Debbia C, Nanni L, Chiappa S, Minute M, Corsini I, Morabito G, Gortan AJ, Colombo M, Marchetti F, Garelli D, Piffer A, Cardinale F, Levy N, Curatola A, Gojsina B, Basu S, Barbi E, Sovtic A. Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study. Arch Dis Child 2022; 107:archdischild-2021-323559. [PMID: 35705371 PMCID: PMC9240451 DOI: 10.1136/archdischild-2021-323559] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/28/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Bronchiolitis is the leading acute respiratory tract infection in infants during the winter season. Since the beginning of the SARS-CoV-2 pandemic, a reduction in the number of bronchiolitis diagnoses has been registered. OBJECTIVE The present study aimed to describe the incidence and clinical features of bronchiolitis during the 2020-2021 winter season in a large cohort of children in Europe and Israel, and to clarify the role of SARS-CoV-2. SETTING, PATIENTS, INTERVENTIONS We conducted a multicentre observational cross-sectional study in 23 paediatric emergency departments in Europe and Israel. Clinical and demographic data about all the cases of infants diagnosed with bronchiolitis from 1 October 2020 to 30 April 2021 were collected. For each enrolled patient, diagnostic tests, treatments and outcomes were reported. MAIN OUTCOME MEASURES The main outcome was the prevalence of SARS-CoV-2-positive bronchiolitis. RESULTS Three hundred and fourteen infants received a diagnosis of bronchiolitis during the study period. Among 535 infants who tested positive for SARS-CoV-2, 16 (3%) had bronchiolitis. Median age, male sex predominance, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative groups. Rhinovirus was the most common involved pathogen, while respiratory syncytial virus (RSV) was detected in one case. SARS-CoV-2 bronchiolitis had a mild clinical course, with one patient receiving oxygen supplementation and none requiring paediatric or neonatal intensive care unit admission. CONCLUSIONS During the SARS-CoV-2 pandemic, a marked decrease in the number of bronchiolitis diagnoses and the disappearance of the RSV winter epidemic were observed. SARS-CoV-2-related bronchiolitis was rare and mostly displayed a mild clinical course.
Collapse
Affiliation(s)
- Giorgio Cozzi
- IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
| | | | | | - Antonio Gatto
- Policlinico Universitario Agostino Gemelli, Roma, Italy
| | | | | | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Silvagni
- Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Carla Debbia
- Istituto Giannina Gaslini Istituto Pediatrico di Ricovero e Cura a Carattere Scientifico, Genova, Italy
| | - Laura Nanni
- Azienda Ospedaliero Universitaria Meyer, Firenze, Italy
| | | | - Marta Minute
- Ospedale Regionale Ca Foncello Treviso, Treviso, Italy
| | - Ilaria Corsini
- University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | | | | | | | | | - Arianna Piffer
- Regional Hospital of Bellinzona and Valli, Bellinzona, Switzerland
| | | | - Nitai Levy
- Ruth Rappaport Children's Hospital, Haifa, Israel
| | | | - Bojana Gojsina
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
- University of Belgrade Faculty of Medicine, Beograd, Serbia
| | | | - Egidio Barbi
- IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Aleksandar Sovtic
- Institute for Health Protection of Mother and Child of Serbia 'Dr Vukan Cupic', Beograd, Serbia
- University of Belgrade Faculty of Medicine, Beograd, Serbia
| |
Collapse
|
11
|
Smedberg JR, DiBiase LM, Hawken SE, Allen A, Mohan S, Santos C, Smedberg T, Barzin AH, Wohl DA, Miller MB. Reduction and persistence of co-circulating respiratory viruses during the SARS-CoV-2 pandemic. Am J Infect Control 2022; 50:1064-1066. [PMID: 35709970 PMCID: PMC9188982 DOI: 10.1016/j.ajic.2022.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
To evaluate co-circulation of respiratory viruses during the SARS-CoV-2 Alpha surge, we performed a molecular respiratory panel on 1,783 nasopharyngeal swabs collected between January 15 and April 15, 2021 from symptomatic outpatients that tested negative for SARS-CoV-2 in North Carolina. Of these, 373 (20.9%) were positive for at least one virus tested on the panel. Among positive tests, over 90% were positive for rhinovirus/enterovirus, either as a single infection or coinfection, illustrating persistent co-circulation of some respiratory viruses despite active infection control measures.
Collapse
Affiliation(s)
- Jason R Smedberg
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, University of North Carolina Medical Center, Chapel Hill, NC
| | - Lauren M DiBiase
- Department of Hospital Epidemiology, University of North Carolina Medical Center, Chapel Hill, NC
| | - Shawn E Hawken
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, University of North Carolina Medical Center, Chapel Hill, NC
| | - Anika Allen
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, University of North Carolina Medical Center, Chapel Hill, NC
| | - Suniti Mohan
- Department of Allied Health Sciences, UNC School of Medicine, Chapel Hill, NC
| | - Courtney Santos
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, University of North Carolina Medical Center, Chapel Hill, NC
| | - Tandy Smedberg
- Department of Information Services, HonorBridge, Durham, NC
| | - Amir H Barzin
- Department of Family Medicine. UNC School of Medicine, Chapel Hill, NC
| | - David A Wohl
- Department of Medicine, Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC
| | - Melissa B Miller
- Clinical Microbiology Laboratory, McLendon Clinical Laboratories, University of North Carolina Medical Center, Chapel Hill, NC; Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, NC
| |
Collapse
|
12
|
Cozzi G, Blasutig F, De Nardi L, Giangreco M, Barbi E, Amaddeo A. The first winter of social distancing improved most of the health indexes in a paediatric emergency department. Acta Paediatr 2022; 111:1027-1033. [PMID: 35080037 PMCID: PMC9303403 DOI: 10.1111/apa.16271] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 12/23/2022]
Abstract
Aim We compared visits to a tertiary level paediatric emergency department (PED) in Italy, during winter 2020–2021, when COVID‐19 social distancing measures were in place, with winter 2019–2020. Methods This was a retrospective analysis of an electronic database. We obtained the number of visits and the ages, main complaints, triage codes, discharge diagnoses and outcomes of patients who accessed the PED from the 1 October 2020 to 28 February 2021. These were compared to the same period in 2019–2021. Results Visits fell by 52%, from 10982 in 2019–2020 to 5317 in 2020–2021 (p < 0.0001). The reductions were 52% in neonates, 58% in infants, 53% in toddlers, 61% in preschool children, 48% in school children and 46% in adolescents. Non‐urgent and urgent triage codes declined. Respiratory and gastrointestinal infections fell by 72% and 71% respectively. Injuries declined by 42%, mainly among adolescents. Accidental intoxication, psychiatric symptoms and substance or alcohol abuse declined by 24%, 33% and 64%. Hospital admissions reduced by 8% and admissions to intensive care fell by 29%. Conclusion During the first winter of pandemic social distancing visits to an Italian PED fell by 52%, with higher reductions in younger children and infants, and hospital admissions fell by 8%.
Collapse
Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy
| | - Francesca Blasutig
- Department of Medicine University of Trieste Surgery and Health Sciences Trieste Italy
| | - Laura De Nardi
- Department of Medicine University of Trieste Surgery and Health Sciences Trieste Italy
| | - Manuela Giangreco
- Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy
| | - Egidio Barbi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy
- Department of Medicine University of Trieste Surgery and Health Sciences Trieste Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health IRCCS Burlo Garofolo Trieste Italy
| |
Collapse
|
13
|
Armocida B, Zamagni G, Magni E, Monasta L, Comar M, Zanotta N, Cason C, Argentini G, Urriza M, Cassone A, Vascotto F, Buzzetti R, Barbi E, Del Pin M, Pani P, Knowles A, Carletti C, Concina F, Milinco M, Ronfani L. Clinical, anamnestic, and sociodemographic predictors of positive SARS-CoV-2 testing in children: A cross sectional study in a tertiary hospital in Italy. PLoS One 2022; 17:e0262923. [PMID: 35077483 PMCID: PMC8789147 DOI: 10.1371/journal.pone.0262923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/07/2022] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES We aimed to identify clinical, anamnestic, and sociodemographic characteristics associated with a positive swab for SARS-CoV2, and to provide a predictive score to identify at risk population in children aged 2-14 years attending school and tested for clinical symptoms of COVID-19. DESIGN Cross sectional study. SETTING Outpatient clinic of the IRCCS Burlo Garofolo, a maternal and child health tertiary care hospital and research centre in Italy. DATA COLLECTION AND ANALYSIS Data were collected through a predefined form, filled out by parents, and gathered information on sociodemographic characteristics, and specific symptoms, which were analysed to determine their association with a positive SARS-CoV-2 swab. The regression coefficients of the variables included in the multivariate analysis were further used in the calculation of a predictive score of the positive or negative test. RESULTS Between September 20th and December 23rd 2020, from 1484 children included in the study, 127 (8.6%) tested positive. In the multivariate analysis, the variables retained by the model were the presence of contact with a cohabiting, non-cohabiting or unspecified symptomatic case (respectively OR 37.2, 95% CI 20.1-68.7; 5.1, 95% CI 2.7-9.6; 15.6, 95% CI 7.3-33.2); female sex (OR 1.49, 95% CI 1.0-2.3); age (6-10 years old: OR 3.2, 95% CI 1.7-6.1 p<0.001; >10 years old: OR 4.8, 95% CI 2.7-8.8 p<0.001); fever (OR 3.9, 95% CI 2.3-6.4); chills (OR 1.9, 95% CI 1.1-3.3); headache (OR 1.45, 95% CI 0.9-2.4); ageusia (OR 1.3, 95% CI 0.5-4.0); sore throat (OR 0.48, 95% CI 0.3-0.8); earache (OR 0.4, 95% CI 0.1-1.3); rhinorrhoea (OR 0.8, 95% CI 0.5-1.3); and diarrhoea (OR 0.52, 95% CI 0.2-1.1). The predictive score based on these variables generated 93% sensitivity and 99% negative predictive value. CONCLUSIONS The timely identification of SARS-CoV2 cases among children is useful to reduce the dissemination of the disease and its related burden. The predictive score may be adopted in a public health perspective to rapidly identify at risk children.
Collapse
Affiliation(s)
- Benedetta Armocida
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Giulia Zamagni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Elena Magni
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Manola Comar
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
- University of Trieste, Trieste, Italy
| | - Nunzia Zanotta
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Carolina Cason
- Unit of Advanced Microbiology Diagnosis and Translational Research, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Giorgia Argentini
- Medical Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Marianela Urriza
- Medical Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Andrea Cassone
- Health Professions Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Fulvia Vascotto
- Health Professions Direction, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Egidio Barbi
- University of Trieste, Trieste, Italy
- Department of Pediatrics, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | | | - Paola Pani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Alessandra Knowles
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Claudia Carletti
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Federica Concina
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Mariarosa Milinco
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste, Italy
| |
Collapse
|
14
|
Risso FM, Cozzi G, Volonnino M, Cossovel F, Ullmann N, Ciofi degli Atti ML, Amaddeo A, Ghirardo S, Cutrera R, Raponi M. Social distancing during the COVID-19 pandemic resulted in a marked decrease in hospitalisations for bronchiolitis. Acta Paediatr 2022; 111:163-164. [PMID: 34403164 PMCID: PMC8444805 DOI: 10.1111/apa.16075] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/10/2021] [Accepted: 08/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Francesco Maria Risso
- Neonatology and Neonatal Intensive Care Unit Institute for Maternal and Child Health ‐ IRCCS Burlo Garofolo Trieste Italy
| | - Giorgio Cozzi
- Emergency department Institute for Maternal and Child Health ‐ IRCCS Burlo Garofolo Trieste Italy
| | | | | | - Nicola Ullmann
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatric Bambino Gesù Children's Hospital IRCCS Rome Italy
| | - Marta Luisa Ciofi degli Atti
- Clinical, management and technology innovation research unit Medical Direction Bambino Gesù Children's Hospital IRCCS Rome Italy
- Medical Direction Bambino Gesù Children's HospitalIRCCS Rome Italy
| | - Alessandro Amaddeo
- Emergency department Institute for Maternal and Child Health ‐ IRCCS Burlo Garofolo Trieste Italy
| | - Sergio Ghirardo
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatric Bambino Gesù Children's Hospital IRCCS Rome Italy
- Clinical, management and technology innovation research unit Medical Direction Bambino Gesù Children's Hospital IRCCS Rome Italy
| | - Renato Cutrera
- Pediatric Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatric Bambino Gesù Children's Hospital IRCCS Rome Italy
| | - Massimiliano Raponi
- Clinical, management and technology innovation research unit Medical Direction Bambino Gesù Children's Hospital IRCCS Rome Italy
- Medical Direction Bambino Gesù Children's HospitalIRCCS Rome Italy
| |
Collapse
|
15
|
Cozzi G, Molina Ruiz I, Giudici F, Romano S, Grigoletto V, Barbi E, Amaddeo A. Pediatric Emergency Cases in the First Year of the COVID-19 Pandemic in a Tertiary-Level Emergency Setting. Front Pediatr 2022; 10:918286. [PMID: 35844743 PMCID: PMC9279893 DOI: 10.3389/fped.2022.918286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022] Open
Abstract
AIM Emergency cases are uncommon events in the pediatric emergency setting. This study aimed to evaluate the effect of the Coronavirus disease 2019 (COVID-19) pandemic by describing the number and type of pediatric emergency cases that arrived at the pediatric emergency department (PED) of a tertiary-level children's hospital in Italy. METHODS We performed a retrospective study, collecting the main features of pediatric emergency patients who arrived during the first year of the COVID-19 pandemic (March 2020-February 2021) compared to the pre-pandemic period (March 2016-February 2020). RESULTS During the study period, 112,168 patients were visited at the PED, and 237 (0.21%) were emergency cases, median age of 4 years (IQR: 1-12). In the first year of the pandemic, 42 children were coded as emergency cases compared to 195 (49/year) during the pre-pandemic period. The proportion of emergency cases was stable (0.27% during the COVID-19 period versus 0.20% during the pre-COVID-19 period, p = 0.19). No differences were found regarding the age, gender, hour of arrival, and outcome of patients. We found a significant decrease in the proportion of emergency cases related to respiratory diseases (9/42, 21.4% during the COVID-19 period versus 83/195 during the pre-COVID-19 period (42.6%), p = 0.01). CONCLUSION In conclusion, our data suggest that the pandemic had a more significant impact on respiratory emergency cases than on pediatric emergencies in general.
Collapse
Affiliation(s)
- Giorgio Cozzi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Fabiola Giudici
- University of Trieste, Trieste, Italy.,Unit of Biostatistics, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | | | | | - Egidio Barbi
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.,University of Trieste, Trieste, Italy
| | - Alessandro Amaddeo
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| |
Collapse
|
16
|
Kuitunen I, Artama M, Haapanen M, Renko M. Rhinovirus spread in children during the COVID-19 pandemic despite social restrictions-A nationwide register study in Finland. J Med Virol 2021; 93:6063-6067. [PMID: 34228369 PMCID: PMC8426983 DOI: 10.1002/jmv.27180] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 01/20/2023]
Abstract
Social restrictions during the coronavirus disease 2019 pandemic strongly affected the epidemiology of influenza and respiratory syncytial virus (RSV). As rhinovirus seemed to spread despite the restrictions, we aimed to analyze rhinovirus epidemiology in children during the pandemic. This register‐based study used data from the Finnish Infectious Disease Register. Nationwide rhinovirus findings from July 2015 to March 2021 were included and stratified by age (0–4, 5–9, and 10–14). Cumulative 14‐day incidence per 100000 children was calculated. Four thousand five hundred and seventy six positive rhinovirus findings were included, of which 3788 (82.8%) were among children aged 0–4. The highest recorded incidence was 36.2 among children aged 0–4 in October 2017. The highest recorded incidence during the pandemic period was 13.6 in November 2020. The impact of the restrictions was mostly seen among children aged 0–4 years of age in weeks 14–22 in 2020. The incidence has since remained near reference levels in all age groups. Strict restrictions temporarily interrupted the circulation of rhinovirus in spring 2020. Rhinovirus incidence returned to normal levels soon after the harsh restrictions were lifted. These looser social restrictions prevented RSV and influenza seasons but failed to prevent the spread of rhinovirus.
Collapse
Affiliation(s)
- Ilari Kuitunen
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland.,Department of Pediatrics, Mikkeli Central Hospital, Mikkeli, Finland
| | - Miia Artama
- Faculty of Social Sciences, Department of Epidemiology, Tampere University, Tampere, Finland.,Department of Infectious Diseases and Vaccinations, Finnish Institute of Health and Welfare, Tampere, Finland
| | - Marjut Haapanen
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland
| | - Marjo Renko
- Department of Pediatrics, University of Eastern Finland, Institute of Clinical Medicine, Kuopio, Finland.,Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland
| |
Collapse
|
17
|
Ippolito G, La Vecchia A, Umbrello G, Di Pietro G, Bono P, Scalia Catenacci S, Pinzani R, Tagliabue C, Bosis S, Agostoni C, Marchisio PG. Disappearance of Seasonal Respiratory Viruses in Children Under Two Years Old During COVID-19 Pandemic: A Monocentric Retrospective Study in Milan, Italy. Front Pediatr 2021; 9:721005. [PMID: 34422733 PMCID: PMC8374241 DOI: 10.3389/fped.2021.721005] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 07/14/2021] [Indexed: 02/01/2023] Open
Abstract
Background: The containment measures adopted during COVID-19 pandemic have influenced the epidemiology of other respiratory viruses. Aim: We analyzed the modification of the incidence and etiology of lower respiratory tract infections (LRTIs) in young children during COVID-19 pandemic. Methods: Case series of all children under 2 years old hospitalized at a tertiary care Hospital in the Center of Milan, Italy diagnosed with LRTIs in three consecutive winter seasons (from the 1st of November to the last day of February in 2018/2019, 2019/2020 and 2020/2021). We compared the number of hospitalizations and viral detections in the 2020/2021 with the average of 2018/2019 and 2019/2020 (pre-COVID-19) using the Poisson distribution. Results: we enrolled 178 patients (66 from 2018/2019, 96 from 2019/2020, 16 from 2020/2021) 94 males (53%) and 84 females (47%), with a median (IQR) age of 5 (2-13) months. The number of hospitalizations during the 2020/2021 season was 80% lower than the average of the pre-COVID-19 seasons (16 vs. 81, p<0.001). Overall, 171 (96%) patient's nasopharyngeal aspirate (NPA) detected at least one virus (110, 64%, single-detection, 61, 36%, co-detections). In 2020/2021 we observed the disappearance of Respiratory Syncytial virus (0 vs. 54, p < 0.001), Influenza virus (0 vs. 6.5, p = 0.002), Metapneumovirus (0 vs. 8, p < 0.001), Parainfluenza viruses (0 vs. 3.5, p = 0.03) and a significant reduction of Adenovirus (2 vs. 7, p = 0.03), Bocavirus (2 vs. 7.5, p = 0.02) and Enterovirus (1 vs. 5, p = 0.04). No significant difference was found for Rhinoviruses (14 cases vs. 17, p = 0.2), other Coronaviruses (0 vs. 2, p = 0.1), and Cytomegalovirus (1 vs. 1, p = 0.7). Conclusions: We observed a striking reduction in hospitalizations due to LRTIs and a modification of the etiology, with enveloped viruses mainly affected.
Collapse
Affiliation(s)
| | | | | | | | - Patrizia Bono
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Laboratory of Virology, Milan, Italy
| | - Stefano Scalia Catenacci
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intensive Care Unit, Milan, Italy
| | - Raffaella Pinzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Claudia Tagliabue
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Samantha Bosis
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy
| | - Carlo Agostoni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Intermediate Care Unit, Milan, Italy.,Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy
| | - Paola Giovanna Marchisio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Pediatric Highly Intensive Care Unit, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| |
Collapse
|