COVID-19 流行第一年儿童急性中耳炎负担变化趋势。
Trends in Pediatric Acute Otitis Media Burden During the First COVID-19 Year.
机构信息
Faculty of Medicine, Hebrew University in Jerusalem, Jerusalem, Israel.
出版信息
Otol Neurotol. 2022 Aug 1;43(7):e760-e766. doi: 10.1097/MAO.0000000000003581.
OBJECTIVE
To study the changes in acute otitis media (AOM) pediatric emergency department (PED) visits and pediatric admission before and during the first coronavirus disease 2019 (COVID-19) year.
STUDY DESIGN
Retrospective case review.
SETTING
Secondary care center.
PATIENTS
Children younger than 18 years with all-cause and AOM-related PED visits and pediatric admissions for 3 years (March 1, 2018-January 28, 2021) were identified. Children were categorized according to age (0-2, 2-6, and 6-18 yr) and their date of presentation: pre-COVID-19 (yearly average of visits/admissions during the 2 prepandemic years: March 1, 2018-February 28, 2019 and March 1, 2019-February 29, 2020) or COVID-19 year (visits/admissions between March 1, 2020-February 28, 2021).
INTERVENTION
Pre- and post-COVID-19 emergence, alternating lockdowns, kindergarten and school closures, and increased hygiene measures.
MAIN OUTCOME MEASURE
Post- versus pre-COVID-19 AOM PED visit and pediatric admission incidence rate ratios (IRRs), using a generalized estimating equation model with a negative binomial regression calculation, while controlling for monthly fluctuations.
RESULTS
Annual AOM visits/admissions during the pre-COVID-19 and COVID-19 years were 517 and 192 and 256 and 94, respectively (p < 0.05 for both). For children aged 0 to 2 years, AOM visits/admissions significantly decreased during the first COVID-19 year, compared with the pre-COVID years (β = -1.11 [IRR, 0.33; 95% confidence interval [CI], 0.26-0.42; p < 0.005] and β = -1.12 [IRR, 0.33; 95% CI, 0.25-0.42; p < 0.005]). Relatively to all-cause of children aged 0 to 2 years, AOM visits/admissions decreased during the first COVID-19 year versus the pre-COVID-19 years (β = -2.14 [IRR, 0.12; 95% CI, 0.08-0.17; p < 0.005] and β = -1.36 [IRR, 0.26; 95% CI, 0.23-0.29; p < 0.005]) and had monthly fluctuations coinciding with the lockdown/relaxation measures. For children aged 2 to 6 years, the reduction in AOM admissions was significant (β = -1.70, IRR, 0.18; 95% CI, 0.09-0.37; p < 0.005). No significant differences were observed for children aged 6 to 18 years because of the small sample size.
CONCLUSION
Pediatric AOM burden substantially decreased during the first COVID-19 year.
目的
研究 2019 年冠状病毒病（COVID-19）首年前后小儿急性中耳炎（AOM）儿科急诊（PED）就诊量和儿科住院量的变化。
研究设计
回顾性病例分析。
设置
二级保健中心。
患者
3 年间（2018 年 3 月 1 日-2021 年 1 月 28 日）所有病因和 AOM 相关 PED 就诊量和儿科住院量的年龄小于 18 岁的儿童。根据年龄（0-2、2-6 和 6-18 岁）和就诊日期将儿童分为两类：COVID-19 前（大流行前 2 年的年平均就诊/住院量：2018 年 3 月 1 日-2 月 28 日和 2019 年 3 月 1 日-2 月 29 日）或 COVID-19 年（2020 年 3 月 1 日-2 月 28 日期间的就诊/住院量）。
干预措施
COVID-19 出现前后，交替封锁、幼儿园和学校关闭，以及增加卫生措施。
主要观察指标
使用具有负二项回归计算的广义估计方程模型，控制每月波动，比较 COVID-19 前后 AOM PED 就诊和儿科住院的发病率比值（IRR）。
结果
COVID-19 前和 COVID-19 年的年度 AOM 就诊/住院量分别为 517 次和 192 次，256 次和 94 次（均 P < 0.05）。对于 0 至 2 岁的儿童，与 COVID-19 前年份相比，第一个 COVID-19 年 AOM 就诊/住院量明显减少（β = -1.11[IRR，0.33；95%置信区间[CI]，0.26-0.42；p < 0.005]和 β = -1.12[IRR，0.33；95%CI，0.25-0.42；p < 0.005]）。与 0 至 2 岁儿童的所有病因相比，AOM 就诊/住院量在第一个 COVID-19 年减少，而在 COVID-19 前年份增加（β = -2.14[IRR，0.12；95%CI，0.08-0.17；p < 0.005]和 β = -1.36[IRR，0.26；95%CI，0.23-0.29；p < 0.005]），并且与封锁/放松措施的时间相吻合。对于 2 至 6 岁的儿童，AOM 住院量的减少具有统计学意义（β = -1.70，IRR，0.18；95%CI，0.09-0.37；p < 0.005）。由于样本量较小，6 至 18 岁的儿童未观察到显著差异。
结论
在第一个 COVID-19 年，小儿 AOM 负担明显减少。
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