Cohen Pr Robert, Rybak Alexis, Werner Andreas, Béchet Stéphane, Desandes Roxane, Hassid Fréderic, André Jean-Marie, Gelbert Nathalie, Thiebault Georges, Kochert Fabienne, Cahn-Sellem Fabienne, Vié Le Sage François, Angoulvant Pr François, Ouldali Naïm, Frandji Bruno, Levy Corinne
ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, Créteil, France.
Clinical Research Center (CRC), Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Lancet Reg Health Eur. 2022 Nov;22:100497. doi: 10.1016/j.lanepe.2022.100497. Epub 2022 Aug 23.
Covid-19 pandemic control has imposed several non-pharmaceutical interventions (NPIs). Strict application of these measures has had a dramatic reduction on the epidemiology of several infectious diseases. As the pandemic is ongoing for more than 2 years, some of these measures have been removed, mitigated, or less well applied. The aim of this study is to investigate the trends of pediatric ambulatory infectious diseases before and up to two years after the onset of the pandemic.
We conducted a prospective surveillance study in France with 107 pediatricians specifically trained in pediatric infectious diseases. From January 2018 to April 2022, the electronic medical records of children with an infectious disease were automatically extracted. The annual number of infectious diseases in 2020 and 2021 was compared to 2018-2019 and their frequency was compared by logistic regression.
From 2018 to 2021, 185,368 infectious diseases were recorded. Compared to 2018 (47,116) and 2019 (51,667), the annual number of cases decreased in 2020 (35,432) by about a third. Frequency of scarlet fever, tonsillopharyngitis, enteroviral infections, bronchiolitis, and gastroenteritis decreased with OR varying from 0·6 (CI95% [0·5;0·7]) to 0·9 (CI95% [0·8;0·9]), 0·001. In 2021, among the 52,153 infectious diagnoses, an off-season rebound was observed with increased frequency of enteroviral infections, bronchiolitis, gastroenteritis and otitis with OR varying from 1·1 (CI95% [1·0;1·1]) to 1·5 (CI95% [1·4;1·5]), 0·001.
While during NPIs strict application, the overall frequency of community-acquired infections was reduced, after relaxation of these measures, a rebound of some of them (enteroviral infections, bronchiolitis, gastroenteritis, otitis) occurred beyond the pre-pandemic level. These findings highlight the need for continuous surveillance of infectious diseases, especially insofar as future epidemics are largely unpredictable.
ACTIV, AFPA, GSK, MSD, Pfizer and Sanofi.
新冠疫情防控实施了多项非药物干预措施（NPIs）。严格执行这些措施已使多种传染病的流行情况大幅减少。由于疫情已持续两年多，其中一些措施已被取消、放宽或执行不力。本研究的目的是调查疫情暴发前及暴发后两年内儿童门诊传染病的趋势。
我们在法国开展了一项前瞻性监测研究，有107名专门接受过儿童传染病培训的儿科医生参与。从2018年1月至2022年4月，自动提取患有传染病儿童的电子病历。将2020年和2021年传染病的年发病数与2018 - 2019年进行比较，并通过逻辑回归比较其发病频率。
2018年至2021年，共记录了185,368例传染病病例。与2018年（47,116例）和2019年（51,667例）相比，2020年的年病例数（35,432例）减少了约三分之一。猩红热、扁桃体咽炎、肠道病毒感染、细支气管炎和肠胃炎的发病频率降低，比值比（OR）在0.6（95%置信区间[0.5;0.7]）至0.9（95%置信区间[0.8;0.9]）之间，P<0.001。2021年，在52,153例传染病诊断病例中，观察到非流行季节的反弹，肠道病毒感染、细支气管炎、肠胃炎和中耳炎的发病频率增加，OR在1.1（95%置信区间[1.0;1.1]）至1.5（95%置信区间[1.4;1.5]）之间，P<0.001。
在严格执行非药物干预措施期间，社区获得性感染的总体频率降低，但在这些措施放宽后，其中一些感染（肠道病毒感染、细支气管炎、肠胃炎、中耳炎）出现反弹，超过了疫情前的水平。这些发现凸显了对传染病进行持续监测的必要性，特别是鉴于未来疫情在很大程度上不可预测。
ACTIV、AFPA、葛兰素史克、默克雪兰诺、辉瑞和赛诺菲。
