Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus Denmark.
Lancet Child Adolesc Health. 2024 Dec;8(12):910-920. doi: 10.1016/S2352-4642(24)00236-0.
The rates of most paediatric infectious diseases declined during the initial phase of the COVID-19 pandemic due to the implementation of non-pharmaceutical interventions. However, after the gradual release of these interventions, resurgences of infections occurred with notable variations in incidence, clinical manifestations, pathogen strains, and age distribution. This Review seeks to explore these changes and the rare clinical manifestations that were made evident during the resurgence of known childhood infections. The magnitude of resurgences was possibly caused by a profound population immunity debt to specific pathogens in combination with the coinciding reappearance of viral and bacterial infections, rather than novel pathogen variants, increased antimicrobial resistance, or altered childhood immune function. As the usual patterns of paediatric infectious diseases were disrupted during the COVID-19 pandemic, the consequences of a population immunity debt were unravelled, and new insights into pathogen transmissibility, disease pathogenesis, and rare clinical manifestations were revealed.
由于实施了非药物干预措施，大多数儿科传染病的发病率在 COVID-19 大流行的初始阶段有所下降。然而，随着这些干预措施的逐步放松，感染再次出现，发病率、临床表现、病原体株和年龄分布都有明显变化。本综述旨在探讨这些变化以及在已知儿童感染再次出现时表现出的罕见临床表现。再次感染的严重程度可能是由于对特定病原体的人群免疫严重不足，再加上病毒和细菌感染同时再次出现，而不是新型病原体变异、抗生素耐药性增加或儿童免疫功能改变所致。由于 COVID-19 大流行期间儿科传染病的常见模式被打乱，人群免疫不足的后果逐渐显现，人们对病原体传播力、疾病发病机制和罕见临床表现有了新的认识。
