Nomden Mark, Alizai Naved K, Betalli Pietro, Bruggink Janneke L M, Cananzi Mara, Christensen Vibeke Brix, D'Antiga Lorenzo, Davenport Mark, Fischler Björn, Hindemith Luise, Hukkinen Maria, Johansen Lars S, de Kleine Ruben H, Madadi-Sanjani Omid, Ong Evelyn G P, Pakarinen Mikko P, Petersen Claus, Ruiz Mathias, Schunn Matthias, Sturm Ekkehard, Verkade Henkjan J, Wildhaber Barbara E, Hulscher Jan B F
Division of Paediatric Surgery, Department of Surgery, University of Groningen, University Medical Centre Groningen, 9713 GZ Groningen, The Netherlands.
European Reference Network for Hepatological Diseases (ERN RARE-LIVER), D-20246 Hamburg, Germany.
J Clin Med. 2023 Jan 18;12(3):775. doi: 10.3390/jcm12030775.
Biliary atresia (BA) is a rare cholangiopathy where one of the proposed aetiological mechanisms is an infectious viral trigger. Coronavirus disease-19 (COVID) lockdown restrictions were implemented to reduce the transmission of infections. Strictness of lockdown varied across European countries. This study aimed to investigate if there was an association between strictness of lockdown and change in isolated BA (IBA) incidence in Europe.
We approached European centres involved in the European Reference Network RARE-LIVER. We included IBA patients born between 2015 and June 2020. We calculated the number of IBA patients born per centre per month. The Stringency Index (SI) was used as lockdown strictness indicator. The association between percentage change of mean number of IBA patients born per month and the SI was assessed.
We included 412 IBA patients from thirteen different centres. The median number of patients per month did not change: 6 (1-15) pre-lockdown and 7 (6-9) during lockdown ( = 0.34). There was an inverse association between SI and percentage change in IBA (B = -0.73, = 0.03). Median age at Kasai portoenterostomy (days) did not differ between time periods (51 (9-179) vs. 53 (19-126), = 0.73).
In this European study, a stricter COVID-lockdown was seemingly accompanied by a simultaneous larger decrease in the number of IBA patients born per month in the lockdown. Results should be interpreted with caution due to the assumptions and limitations of the analysis.
胆道闭锁（BA）是一种罕见的胆管病，其提出的病因机制之一是感染性病毒触发因素。实施冠状病毒病-19（COVID）封锁限制措施以减少感染传播。欧洲各国的封锁严格程度各不相同。本研究旨在调查欧洲封锁的严格程度与孤立性胆道闭锁（IBA）发病率变化之间是否存在关联。
我们联系了参与欧洲罕见肝脏参考网络的欧洲中心。纳入了2015年至2020年6月期间出生的IBA患者。我们计算了每个中心每月出生的IBA患者数量。使用严格指数（SI）作为封锁严格程度指标。评估每月出生的IBA患者平均数量的百分比变化与SI之间的关联。
我们纳入了来自13个不同中心的412例IBA患者。每月患者中位数没有变化：封锁前为6例（1 - 15例），封锁期间为7例（6 - 9例）（P = 0.34）。SI与IBA的百分比变化之间存在负相关（B = -0.73，P = 0.03）。两个时间段之间，Kasai肝门空肠吻合术时的中位年龄（天）没有差异（51天（9 - 179天）对53天（19 - 126天），P = 0.73）。
在这项欧洲研究中，更严格的COVID封锁似乎伴随着封锁期间每月出生的IBA患者数量同时更大幅度的下降。由于分析的假设和局限性，结果应谨慎解释。
