Assad Zein, Trad Maelle, Valtuille Zaba, Dumaine Cécile, Faye Albert, Ikowsky Tania, Kaguelidou Florentia, Osei Lindsay, Ouldali Naim, Meinzer Ulrich
Department of General Paediatrics, Paediatric Internal Medicine, Rheumatology and Infectious Diseases, National Reference Centre for Rare Paediatric Inflammatory Rheumatisms and Systemic Autoimmune Diseases (RAISE), Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, F-75019, Paris, France.
Department of Paediatrics, Cayenne Hospital, F-97300, Cayenne, French Guiana, France.
Lancet Reg Health Eur. 2024 Dec 6;49:101159. doi: 10.1016/j.lanepe.2024.101159. eCollection 2025 Feb.
Scurvy, historically rare in-high income countries, has re-emerged as an indicator of socioeconomic and dietary disparities. Limited data exist on scurvy trends among European children, particularly following socioeconomic changes since the COVID-19 pandemic. This study analysed scurvy incidence trends among French children over a nine-year period, examining potential post-pandemic increases.
This cohort study used an interrupted time-series analysis of patient records from a national hospital-based French surveillance system. All children aged <18 years hospitalized with scurvy and malnutrition from January 2015 to November 2023 were included. The monthly incidence of hospitalized scurvy per 100,000 children was analysed using a segmented linear regression model with autoregressive error. Incidence of hospitalization for malnutrition was analysed as secondary outcome and for urinary tract infection and vitamin D deficiency as control outcomes.
A total of 888 children were hospitalized with scurvy (median age, 11 years; interquartile range [IQR], 4-15; 431 boys [48.5%]). The COVID-19 pandemic in March 2020 was associated with a significant increase in scurvy incidence (cumulative increase, 34.5%; 95% confidence interval [CI], 12.7-56.3; p = 0.002) and severe malnutrition (cumulative increase, 20.3%; 95% CI, 10.7-29.9; p < 0.001). The increased incidence of scurvy was correlated with the rise in the consumer price index. In contrast, no change was found for the two control outcomes.
This study identifies a significant increase in scurvy and severe malnutrition post-COVID-19, associated with inflation and socioeconomic instability, emphasizing the urgent need for targeted nutritional support for at-risk paediatric populations.
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坏血病在高收入国家历史上较为罕见，但如今已再度出现，成为社会经济和饮食差异的一个指标。关于欧洲儿童坏血病趋势的数据有限，尤其是自新冠疫情以来社会经济发生变化之后。本研究分析了法国儿童在九年期间的坏血病发病率趋势，考察疫情后是否有潜在的上升情况。
这项队列研究对法国一个基于全国医院的监测系统中的患者记录进行了中断时间序列分析。纳入了2015年1月至2023年11月期间因坏血病和营养不良住院的所有18岁以下儿童。使用带有自回归误差的分段线性回归模型分析每10万名儿童中住院坏血病的月度发病率。将营养不良的住院发病率作为次要结果进行分析，将尿路感染和维生素D缺乏的发病率作为对照结果进行分析。
共有888名儿童因坏血病住院（中位年龄11岁；四分位间距[IQR]为4 - 15岁；431名男孩[48.5%]）。2020年3月的新冠疫情与坏血病发病率显著上升（累积上升34.5%；95%置信区间[CI]为12.7 - 56.3；p = 0.002）以及严重营养不良（累积上升20.3%；95% CI为10.7 - 29.9；p < 0.001）相关。坏血病发病率的上升与消费价格指数的上升相关。相比之下，两个对照结果未发现变化。
本研究发现新冠疫情后坏血病和严重营养不良显著增加，与通货膨胀和社会经济不稳定相关，强调了迫切需要为高危儿科人群提供有针对性的营养支持。
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