以色列首例 COVID-19 两年间儿童急性中耳炎负担的波动。

Fluctuations in Pediatric Acute Otitis Media Burden During the First Two COVID-19 Years in Israel.

机构信息

Clalit Health Services, Tel Aviv, Israel.

Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel.

出版信息

Pediatr Infect Dis J. 2023 Feb 1;42(2):146-151. doi: 10.1097/INF.0000000000003767. Epub 2022 Nov 8.

DOI:10.1097/INF.0000000000003767

PMID:36638402

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9838606/

Abstract

BACKGROUND

To study pediatric acute otitis media (AOM) burden fluctuations before and during the first two COVID years, which were characterized by measures to reduce the spread of airborne diseases. We used urinary tract infection (UTI) as a comparison infection.

METHODS

This was a cross-sectional study encompassing three pre-COVID years (March 1, 2017-February 29, 2020) and the first two COVID years (March 1, 2020-February 28, 2021, and March 1, 2021-February 28, 2022). Records were retrieved from the Clalit Health Services database, Israel's largest healthcare maintenance organization. Children 0-15 years with AOM and UTI episodes were categorized according to age (1>, 1-4, 5-15 years). We collected demographics, seasonality, AOM complications, antibiotic prescriptions, and recent COVID-19 infections. The average AOM/UTI rates of the three pre-COVID years vs. two COVID years were used to calculate the incidence rate ratios (IRRs).

RESULTS

We identified 1,102,826 AOM and 121,263 UTI episodes. The median age at AOM diagnosis was 2.0 years (IQR, 1.1-4.1). Male predominance, age at presentation, and the dominant age group of 1-4 years did not change during the COVID years. While UTI episode rates decreased during the COVID years (IRR 0.76, 95% CI, 0.68-0.84, P < 0.001), the reduction in AOM episode rates was >2-fold (IRR 0.46, 95% CI, 0.34-0.63, P < 0.001). The largest decrease was observed among children 1-4 years old during the first COVID year (β=-1,938 AOM episodes/100,00 children, 95% CI, -2,038 to -1,912, P < 0.001). Recent COVID-19 infection was associated with low AOM morbidity (IRR 0.05, 95% CI 0.05-0.05, P < 0.001).

CONCLUSIONS

AOM burden substantially decreased during the first COVID year but almost reached pre-pandemic levels during the second year.

摘要

背景

研究小儿急性中耳炎（AOM）在 COVID 前两年和前两年期间的负担波动，这两年的特点是采取了减少空气传播疾病传播的措施。我们将尿路感染（UTI）作为比较感染。

方法

这是一项横断面研究，包括 COVID 前三年（2017 年 3 月 1 日至 2020 年 2 月 29 日）和 COVID 前两年（2020 年 3 月 1 日至 2021 年 2 月 28 日和 2021 年 3 月 1 日至 2022 年 2 月 28 日）。记录从以色列最大的医疗保健维护组织 Clalit 健康服务数据库中检索。根据年龄（1 岁以上、1-4 岁、5-15 岁）将患有 AOM 和 UTI 发作的 0-15 岁儿童分类。我们收集了人口统计学数据、季节性、AOM 并发症、抗生素处方和最近的 COVID-19 感染情况。使用 COVID 前三年和前两年的平均 AOM/UTI 率来计算发病率比（IRR）。

结果

我们确定了 1,102,826 例 AOM 和 121,263 例 UTI 发作。AOM 诊断的中位年龄为 2.0 岁（IQR，1.1-4.1）。男性占优势、就诊年龄以及 1-4 岁的主要年龄组在 COVID 年间没有改变。虽然 UTI 发作率在 COVID 年间下降（IRR 0.76，95%CI，0.68-0.84，P < 0.001），但 AOM 发作率的下降幅度超过两倍（IRR 0.46，95%CI，0.34-0.63，P < 0.001）。最大的降幅发生在 COVID 第一年的 1-4 岁儿童中（β=-1,938 例 AOM/100,000 儿童，95%CI，-2,038 至-1,912，P < 0.001）。最近的 COVID-19 感染与较低的 AOM 发病率相关（IRR 0.05，95%CI 0.05-0.05，P < 0.001）。