Division of Emergency Medical Services, Department of Emergency Medicine, The Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI 02903, USA.
Department of Emergency Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Int J Environ Res Public Health. 2022 Dec 2;19(23):16152. doi: 10.3390/ijerph192316152.
Background: Infectious diseases, including COVID-19, have a severe impact on child health globally. We investigated whether emergency medical service (EMS) calls are a bellwether for future COVID-19 caseloads. We elaborated on geographical hotspots and socioeconomic risk factors. Methods: All EMS calls for suspected infectious disease in the pediatric population (under 18 years of age) in Rhode Island between 1 March 2018 and 28 February 2022 were included in this quasi-experimental ecological study. The first of March 2020 was the beginning of the COVID-19 pandemic. We used the 2020 census tract and the most recent COVID-19 data. We investigated associations between pediatric EMS calls and positive COVID-19 tests with time series analysis and identified geographical clusters using local indicators of spatial association. Economic risk factors were examined using Poisson regression. Results: We included 980 pediatric ambulance calls. Calls during the omicron wave were significantly associated with increases in positive COVID-19 tests one week later (p < 0.001). Lower median household income (IRR 0.99, 95% CI [0.99, 0.99]; p < 0.001) and a higher child poverty rate (IRR 1.02, 95% CI [1.02, 1.02]; p < 0.001) were associated with increased EMS calls. Neighborhood hotspots changed over time. Conclusion: Ambulance calls might be a predictor for major surges of COVID-19 in children.
传染病，包括 COVID-19，对全球儿童健康造成严重影响。我们研究了紧急医疗服务（EMS）呼叫是否是 COVID-19 病例未来增长的先兆。我们详细阐述了地理热点和社会经济风险因素。
本研究为一项准实验性生态研究，纳入 2018 年 3 月 1 日至 2022 年 2 月 28 日罗德岛儿科人群（18 岁以下）因疑似传染病拨打的所有 EMS 电话。2020 年 3 月 1 日是 COVID-19 大流行的开始。我们使用了 2020 年的普查区和最新的 COVID-19 数据。我们使用时间序列分析调查了儿科 EMS 呼叫与 COVID-19 阳性检测之间的关联，并使用局部空间关联指标识别地理聚集区。使用泊松回归检验经济风险因素。
我们纳入了 980 例儿科救护车呼叫。与 omicron 波相关的呼叫与一周后 COVID-19 阳性检测的增加显著相关（p < 0.001）。较低的中位数家庭收入（IRR 0.99，95%CI [0.99, 0.99]；p < 0.001）和较高的儿童贫困率（IRR 1.02，95%CI [1.02, 1.02]；p < 0.001）与 EMS 呼叫增加相关。邻里热点随时间而变化。
救护车呼叫可能是儿童 COVID-19 大规模激增的预测指标。
