Heart Center, Qingdao Women and Children's Hospital, Qingdao University, 6 Tongfu Road, Shibei District, Qingdao, 266034, Shandong, China.
Ital J Pediatr. 2022 Dec 12;48(1):198. doi: 10.1186/s13052-022-01384-6.
It is reported that the adverse impact of nonpharmaceutical interventions (NPIs) on the mental health of children and adolescents may lead to psychologically related disorders during the coronavirus disease 2019 (COVID-19) period. Subject symptoms such as chest pain, chest tightness, and palpitation may be related to increased stress and anxiety in children and adolescents. The present research aimed to determine the number of pediatric consults and etiology of subject symptoms during the COVID-19 pandemic period and compared it with the same timelines in 2019 and 2021 to discuss the impact of different periods on the organic disease onset of children with subject symptoms, especially in cardiac involvement.
Children who visited Qingdao Women and Children's Hospital, Qingdao University between January 23 to April 30, 2019 (pre-COVID-19 period), January 23 to April 30, 2020 (COVID-19 period), and January 23 to April 30, 2021 (post-COVID-19 period) presenting chest pain, chest tightness, and palpitation were recruited. Information to determine gender, age, medical history, department for the initial visit, clinical manifestations, time from the latest onset to the visit, and diagnosis were recorded.
A total of 891 patients were enrolled in the present study (514 males; median age: 7.72). One hundred twenty-three patients presented during the pre-COVID-19 period while 130 during the COVID-19 period, nevertheless, the number substantially increased during the post-COVID-19 period (n = 638). Cardiac etiology accounted for 1.68% (n = 15) of the patient population, including arrhythmias (n = 10, 1.12%), myocarditis (n = 4, 0.44%), and atrial septal defect (n = 1, 0.11%). There was no significant difference among groups in the distribution of organic etiology. The median time from the latest onset to the visit during the pre-COVID-19 period was 7 days compared to 10 days during the COVID-19 period and 3 days during the post-COVID period.
During the post-COVID-19 period, the median time from the latest onset to the visit was significantly shorter than that in the pre-COVID-19 period or COVID-19 period. The pediatric consult of children with subject symptoms presented increased substantially during the post-COVID-19 period, while there was no significant difference in the number of patients involving the cardiac disease. Clinicians ought to be more careful to screen heart diseases to prevent missed diagnosis and misdiagnosis during special periods.
据报道，非药物干预措施（NPIs）对儿童和青少年心理健康的不良影响可能导致 2019 年冠状病毒病（COVID-19）期间出现与心理相关的障碍。儿童和青少年的胸部疼痛、胸闷和心悸等躯体症状可能与压力和焦虑增加有关。本研究旨在确定 COVID-19 大流行期间儿科就诊人数和躯体症状的病因，并与 2019 年和 2021 年同期进行比较，以讨论不同时期对出现躯体症状的儿童器质性疾病发病的影响，特别是心脏受累。
招募 2019 年 1 月 23 日至 4 月 30 日（COVID-19 前）、2020 年 1 月 23 日至 4 月 30 日（COVID-19 期间）和 2021 年 1 月 23 日至 4 月 30 日（COVID-19 后）期间因胸痛、胸闷和心悸就诊于青岛大学附属妇女儿童医院的儿童。记录性别、年龄、既往史、初诊科室、临床表现、从末次发病到就诊的时间和诊断等信息。
本研究共纳入 891 例患者（男性 514 例；中位年龄：7.72 岁）。123 例患者在 COVID-19 前就诊，130 例在 COVID-19 期间就诊，但 COVID-19 后就诊人数显著增加（n=638）。心脏病因占患者人群的 1.68%（n=15），包括心律失常（n=10，1.12%）、心肌炎（n=4，0.44%）和房间隔缺损（n=1，0.11%）。各组间器质性病因的分布无统计学差异。COVID-19 前就诊的中位末次发病至就诊时间为 7 天，COVID-19 期间为 10 天，COVID-19 后为 3 天。
COVID-19 后，末次发病至就诊的中位时间明显短于 COVID-19 前或 COVID-19 期间。COVID-19 后，出现躯体症状的儿童儿科就诊人数显著增加，但心脏疾病患者人数无显著差异。临床医生在特殊时期应更加小心筛查心脏疾病，以防止漏诊和误诊。
