Frontiers in Pediatrics (Mar 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,
  • Alexis Rybak,
  • Alexis Rybak,
  • Naïm Ouldali,
  • Naïm Ouldali,
  • Naïm Ouldali,
  • François Angoulvant,
  • François Angoulvant,
  • François Angoulvant,
  • Philippe Minodier,
  • Philippe Minodier,
  • Sandra Biscardi,
  • Sandra Biscardi,
  • Fouad Madhi,
  • Fouad Madhi,
  • Isabelle Hau,
  • Isabelle Hau,
  • Audrey Santos,
  • Emilie Bouvy,
  • Emilie Bouvy,
  • François Dubos,
  • François Dubos,
  • Alain Martinot,
  • Alain Martinot,
  • Marie-Aliette Dommergues,
  • Marie-Aliette Dommergues,
  • Christèle Gras-Le Guen,
  • Christèle Gras-Le Guen,
  • Elise Launay,
  • Elise Launay,
  • Karine Levieux,
  • Karine Levieux,
  • Ferielle Zenkhri,
  • Ferielle Zenkhri,
  • Irina Craiu,
  • Irina Craiu,
  • Mathie Lorrot,
  • Mathie Lorrot,
  • Yves Gillet,
  • Yves Gillet,
  • Ellia Mezgueldi,
  • Ellia Mezgueldi,
  • Albert Faye,
  • Albert Faye,
  • Albert Faye,
  • Stéphane Béchet,
  • Stéphane Béchet,
  • Emmanuelle Varon,
  • Emmanuelle Varon,
  • Robert Cohen,
  • Robert Cohen,
  • Robert Cohen,
  • Robert Cohen,
  • Robert Cohen,
  • Corinne Levy,
  • Corinne Levy,
  • Corinne Levy,
  • Corinne Levy

DOI
https://doi.org/10.3389/fped.2022.782894
Journal volume & issue
Vol. 10

Abstract

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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.

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