COVID-19 mitigation strategies reduced hospital admissions for childhood infections
By Shreeya Nanda, medwireNews Reporter
UK researchers have found marked reductions in hospital admissions for a wide range of common and severe childhood infections in England in the 12 months after the start of the COVID-19 pandemic.
They also observed corresponding decreases in absolute numbers of deaths within 60 days of hospital admission.
“The findings indicate the extent to which measures related to the control of covid-19 can also impact on the transmission of other specific infectious diseases in childhood”, write Seilesh Kadambari and colleagues from the University of Oxford in The BMJ.
They continue: “Further evaluation of non-pharmacological interventions that could be sustained beyond the pandemic is required to inform policy makers about potential strategies, especially during winter months, to minimise the burden on health systems and protect vulnerable children.
“Continued monitoring of hospital admissions for these infections is required as social restrictions evolve.”
The researchers used National Health Service data and found that hospital admissions for children aged 0–14 years in England reduced substantially for all but one of the 19 studied infections during 1 March 2020–28 February 2021 compared with the preceding 36 months.
The greatest reduction among respiratory infections was observed for influenza, hospital admissions for which decreased by 94% during the pandemic, followed by bronchiolitis, at 82%.
Among the severe invasive infections, decreases in hospital admissions ranged from 26% for osteomyelitis to 50% for meningitis, while the reductions for vaccine-preventable infections ranged from 53% for mumps to 90% for measles.
Pyelonephritis was the only infection for which there was no decrease in hospitalisation rates during versus before the pandemic, but the authors suggest that this “might be because non-pharmacological interventions and social restrictions have no impact on this condition.”
Of note, hospital admissions for SARS-CoV-2 infection peaked in January 2021.
Kadambari and team also looked at hospital admissions from 1 March 2021 onwards and found that admissions for croup were 2.8-fold higher in May 2021 and 2.3-fold higher in June 2021 than the mean number in the corresponding months of 2017–2019, while admissions for upper respiratory tract infections were 1.4-fold higher in June 2021.
“Ongoing clinical and microbiological surveillance is required to evaluate any epidemiological changes (eg, substantial increase in rates, delayed peaks, disease in older infants) in respiratory infections that might have occurred because of a lack of population based immunity during the pandemic”, they say.
The investigators were also able to analyse 60-day mortality data for sepsis, meningitis, bronchiolitis, pneumonia, viral wheeze and upper respiratory tract infections, finding that the absolute numbers of deaths decreased for all six conditions in the 12 months after the start of the pandemic.
They highlight, however, that for pneumonia “the proportion admitted who died within 60 days increased after the onset of the pandemic”, with an odds ratio of 1.62 relative to the prepandemic period after adjusting for age, sex and comorbidities.
“This increase could be because hospital admissions for pneumonia after 1 March 2020 were generally at the more severe end of the spectrum if people with less severe disease were being more frequently managed outside hospital or because of delays in seeking or difficulty in accessing appropriate healthcare during the pandemic”, comment the study authors.
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BMJ 2022; 376: e067519
Article link https://pubmed.ncbi.nlm.nih.gov/35022215/