Gottlieb Max, Jakanovski Philip, Harding-Forrester Sam, Mitchell Alexander, Liu Sue, Zhang Eva, Al-Ani Aysha, Segal Jonathan, Christensen Britt
Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Department of Anatomical Pathology, Dorevitch Pathology, Melbourne, Victoria, Australia.
Intern Med J. 2025 Feb;55(2):290-296. doi: 10.1111/imj.16597. Epub 2024 Dec 19.
The COVID-19 pandemic resulted in the enactment of substantial public health measures aimed at reducing the transmission of respiratory viruses. The impact of these measures on gastrointestinal (GI) infections remains unexplored.
To determine whether there was a change in the number of patients presenting to The Royal Melbourne Hospital with GI infections during the COVID-19 pandemic compared to the year prior.
We conducted a retrospective, single-centre case-control study comparing the incidence and characteristics of hospitalisations with GI infections from March to August 2019 and across the same months in 2020, corresponding to periods immediately prior to and during the COVID pandemic.
Of 430 presentations with GI infections across both time periods, there was a 51.9% decrease in hospitalisations with GI infections during the pandemic. Patients admitted during the pandemic were more likely to be admitted to the intensive care unit (0.71% vs 3.4%, P < 0.04) and to be prescribed antibiotics (21.9% vs 36.1%, P < 0.01). Length of stay and mortality were unchanged. There was a decline in the number and proportion of patients with positive faecal cultures in 2020, primarily attributed to a significant reduction in Norovirus cases (28% vs 4%) (odds ratio (OR) = 0.093, P < 0.01). Conversely, the proportion of patients presenting with Clostridioides difficile was higher in 2020 (22% vs 44%) (OR = 2.4, P = 0.01).
There was a substantial decrease in hospital admissions with GI infections, particularly Norovirus, during the COVID-19 pandemic. Admissions because of Clostridioides increased. Stringent public health measures reducing interpersonal contact and increased antibiotic prescribing respectively may explain these changes, while an increased reluctance to seek medical care may also have contributed to the sharp overall decrease in hospitalisations.
新冠疫情导致大量公共卫生措施的出台，旨在减少呼吸道病毒的传播。这些措施对胃肠道（GI）感染的影响仍未得到探索。
确定在新冠疫情期间，与前一年相比，墨尔本皇家医院胃肠道感染就诊患者数量是否有变化。
我们进行了一项回顾性、单中心病例对照研究，比较了2019年3月至8月以及2020年同一月份胃肠道感染住院的发生率和特征，这两个时间段分别对应新冠疫情之前和期间。
在两个时间段内的430例胃肠道感染就诊病例中，疫情期间胃肠道感染住院人数减少了51.9%。疫情期间入院的患者更有可能被收入重症监护病房（0.71%对3.4%，P<0.04），并且更有可能被开具抗生素（21.9%对36.1%，P<0.01）。住院时间和死亡率没有变化。2020年粪便培养阳性患者的数量和比例有所下降，主要归因于诺如病毒病例的显著减少（28%对4%）（优势比（OR）=0.093，P<0.01）。相反，2020年艰难梭菌感染患者的比例更高（22%对44%）（OR=2.4，P=0.01）。
在新冠疫情期间，胃肠道感染住院人数大幅下降，尤其是诺如病毒感染。艰难梭菌感染导致的入院人数增加。严格的公共卫生措施分别减少了人际接触和增加了抗生素处方量，这可能解释了这些变化，而就医意愿降低也可能导致了住院人数的大幅整体下降。
