Korematsu Seigo, Fujisawa Takao, Saito Naruo, Tezuka Junichiro, Miura Katsushi, Kobayashi Ichiro, Miyata Ippei, Kosugi Yujiro, Gohda Yuji, Koike Yumi, Suda Ami, Matsuo Akiko, Sasaki Michiyo, Handa Yousuke, Fujiwara Michimasa, Ono Atsushi, Koizumi Shinya, Oishi Taku, Tanaka Takayuki, Ando Yusuke, Taba Naohiko, Tsurinaga Yuki, Sato Takeshi, Kanai Rei, Yashiro Masato, Takagi Toshiyuki, Hida Shinya, Harazaki Masashi, Hoshina Takayuki, Okada Seigo, Yasutomi Motoko, Nakata Setsuko, Muto Ayako, Tanabe Saori, Ueda Yutaka, Hasegawa Shunji, Kameda Makoto, Tanaka-Taya Keiko, Fujimoto Tsuguto, Okada Kenji
Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Allergy Center, NHO Mie National Hospital, Mie, Japan.
Clin Transl Allergy. 2024 Jan;14(1):e12330. doi: 10.1002/clt2.12330.
Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan.
Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated.
From fiscal years 2010-2019, the median number of acute asthma hospitalizations per year was 3524 (2462-4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020-2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma.
SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
儿童急性哮喘发作通常由呼吸道感染引起。在本研究中，建立了一个针对急性哮喘住院病例和致病性呼吸道感染的全国性协调监测系统。我们在此报告日本自新冠疫情以来儿科急性哮喘住院病例的近期趋势。
日本的33家哨点医院登记了所有住院的儿科哮喘患者及其致病病原体。调查了新冠疫情爆发前后儿童急性哮喘住院情况的变化以及新冠病毒是否导致急性哮喘发作。
2010 - 2019财年，每年急性哮喘住院病例的中位数为3524例（2462 - 4570例），但在2020、2021和2022财年，这一数字分别为820例、1001例和1026例（日本财年为4月至次年3月）。除3至6岁年龄组外，所有年龄组均出现了这种下降。在2020 - 2022财年对2094例患者进行了新冠病毒评估，但直到2022年2月才检测到首例阳性病例。从那时起，其中只有36例被确诊感染新冠病毒，无一例需要机械通气。2020财年流感、呼吸道合胞病毒和人偏肺病毒感染也有所减少。相比之下，尽管支气管哮喘病情严重，但24%的患者在入院前未接受长期控制药物治疗。
在新冠疫情期间，急性哮喘住院儿童中几乎未检测到新冠病毒。这一结果表明新冠病毒不会诱发儿童急性哮喘发作。相反，针对疫情实施的感染控制措施可能因此减少了其他呼吸道病毒感染，从而减少了这一时期的急性哮喘住院病例。然而，许多住院患者未接受适当的长期控制药物治疗这一事实是一个需要解决的主要问题。
