Rege Sanika, Parlett Lauren E, Neikirk Amanda, Iizuka Alicia, Yang Yiling, Huang Cecilia, Crystal Stephen, Davidow Amy, Haynes Kevin, Gerhard Tobias, Rose Carlos D, Strom Brian L, Horton Daniel B
From the Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ.
Carelon Research, Inc, Wilmington, DE.
J Clin Rheumatol. 2025 Jan 1;31(1):40-44. doi: 10.1097/RHU.0000000000002154.
BACKGROUND/OBJECTIVE: Little is known about the rates of rheumatic disease diagnosis among children during the COVID-19 pandemic. We examined the impact of the pandemic on the diagnosis of juvenile idiopathic arthritis (JIA) in the United States.
We performed a historical cohort study using US commercial insurance data (2016-2021) to identify children aged <18 years without prior JIA diagnosis or treatment in the prior ≥12 months. New JIA diagnoses were identified using a combination of ICD-10-CM diagnosis codes, location, and timing of medical services. Crude rates with 95% confidence intervals (CIs) of JIA diagnosis per 100,000 enrolled children per quarter were estimated and stratified by age group, sex, region, JIA type, and uveitis. The incidence rate ratio (95% CI) for JIA diagnosis was estimated using Poisson regression, adjusted for various demographic variables.
From 2018-2021, 643 children were diagnosed with JIA. Crude new JIA diagnoses per 100,000 children per quarter dropped from 2.62 (95% CI, 2.39-2.87) prepandemic to 1.94 (95% CI, 1.66-2.25) during the pandemic. Declines in JIA diagnosis were more apparent in the US Northeast and West regions and among children aged 6-11 years. After adjustment for covariates, JIA diagnoses fell by 30% during the pandemic compared with the prior 3 years (IRR, 0.70; 95% CI, 0.59-0.83).
Compared with the prepandemic period, JIA was diagnosed 30% less often during the early pandemic among commercially insured children in the United States. More research is needed to understand the underlying reasons for these changes in JIA diagnosis and more recent trends.
背景/目的：关于新冠疫情期间儿童风湿性疾病的诊断率，人们了解甚少。我们研究了疫情对美国青少年特发性关节炎（JIA）诊断的影响。
我们利用美国商业保险数据（2016 - 2021年）进行了一项历史性队列研究，以识别18岁以下、在过去至少12个月内未被诊断或治疗过JIA的儿童。使用ICD - 10 - CM诊断代码、医疗服务地点和时间的组合来确定新的JIA诊断。估计每季度每10万名登记儿童中JIA诊断的粗发病率及其95%置信区间（CI），并按年龄组、性别、地区、JIA类型和葡萄膜炎进行分层。使用泊松回归估计JIA诊断的发病率比值（95%CI），并对各种人口统计学变量进行调整。
2018 - 2021年，643名儿童被诊断为JIA。每季度每10万名儿童中新发JIA诊断数从疫情前的2.62（95%CI，2.39 - 2.87）降至疫情期间的1.94（95%CI，1.66 - 2.25）。JIA诊断率的下降在美国东北部和西部地区以及6 - 11岁儿童中更为明显。在对协变量进行调整后，与前3年相比，疫情期间JIA诊断数下降了30%（发病率比值，0.70；95%CI，0.59 - 0.83）。
与疫情前相比，美国商业保险儿童在疫情早期JIA的诊断率降低了30%。需要更多研究来了解JIA诊断这些变化的潜在原因以及最新趋势。
