Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Center for Obstetrics and Pediatrics, Hamburg, Germany.
Research Institute Children's Cancer Center, Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Klin Padiatr. 2023 May;235(3):159-166. doi: 10.1055/a-2000-5388. Epub 2023 Feb 27.
Infections are a major concern for immunocompromised children. We investigated whether non-pharmaceutical interventions (NPIs) implemented in the general population during the coronavirus disease 2019 (COVID-19) pandemic in Germany had an impact on frequency, type and severity of infections in these patients.
We analyzed all admissions to the clinic of pediatric hematology, oncology and stem cell transplantation (SCT) with (suspected) infection or fever of unknown origin (FUO) from 2018 to 2021.
We compared a 27-month period before NPIs (Pre-COVID: 01/2018-03/2020; 1041 cases) with a 12-month period with underlying NPIs (COVID: 04/2020-03/2021; 420 cases). During the COVID period the number of in-patient stays with FUO or infections decreased (38,6 cases/month vs. 35,0 cases/month), the median duration of hospital stays was longer (8 d (CI95: 7-8 d) vs. 9 d (CI95: 8-10 d) P=0,02)), the mean number of antibiotics per case increased (2,1 (CI95: 2,0-2,2) vs. 2,5 (CI95: 2,3-2,7); P=0,003)) and a substantial reduction of viral respiratory and gastrointestinal infections per case was seen (0,24 vs. 0,13; P<0,001). Notably, there was no detection of respiratory syncytial virus, influenza and norovirus, between May 2020 and March 2021. Based on need of intensive care measures and further parameters we conclude that severe (bacterial) infections were not significantly reduced by NPIs.
Introduction of NPIs in the general population during the COVID-pandemic substantially reduced viral respiratory and gastrointestinal infections in immunocompromised patients, while severe (bacterial) infections were not prevented.
感染是免疫功能低下儿童的主要关注点。我们研究了德国 2019 年冠状病毒病（COVID-19）大流行期间在普通人群中实施的非药物干预（NPIs）是否对这些患者感染的频率、类型和严重程度有影响。
我们分析了 2018 年至 2021 年所有因（疑似）感染或不明原因发热（FUO）到儿科血液学、肿瘤学和干细胞移植（SCT）诊所就诊的患者。
我们比较了 NPIs 实施前的 27 个月（Pre-COVID：2018 年 1 月至 2020 年 3 月；1041 例）与 NPIs 实施后的 12 个月（COVID：2020 年 4 月至 2021 年 3 月；420 例）。在 COVID 期间，FUO 或感染的住院人数减少（38.6 例/月 vs. 35.0 例/月），住院时间中位数延长（8 d（CI95：7-8 d）vs. 9 d（CI95：8-10 d）P=0.02）），每个病例的抗生素平均数量增加（2.1（CI95：2.0-2.2）vs. 2.5（CI95：2.3-2.7）；P=0.003）），每个病例的病毒呼吸道和胃肠道感染显著减少（0.24 比 0.13；P<0.001）。值得注意的是，2020 年 5 月至 2021 年 3 月期间未检测到呼吸道合胞病毒、流感和诺如病毒。基于需要重症监护措施和其他参数，我们得出结论，非药物干预并没有显著减少严重（细菌）感染。
COVID 大流行期间在普通人群中引入 NPIs 大大减少了免疫功能低下患者的病毒性呼吸道和胃肠道感染，而严重（细菌）感染并未得到预防。
