Foley Kimberley, Hargreaves Dougal, Bottle Alex, Quint Jennifer K, Majeed Azeem, Saglani Sejal, Saxena Sonia
Department of Primary Care and Public Health, Imperial College London, London
Mohn Centre for Children's Health and Wellbeing, Imperial College London, London; Centre for Paediatrics & Child Health, Imperial College London, London.
Br J Gen Pract. 2025 Jun 16. doi: 10.3399/BJGP.2024.0501.
Little is known about how GP consultation rates for children's respiratory tract infections (RTIs) have changed since the COVID-19 pandemic restrictions lifted.
To describe changes in GP consultation rates for RTIs in children aged <5 years from 2016 to 2023.
A population-based retrospective cohort study using electronic health records from primary care practices across England.
All children aged <5 years registered with a general practice in the Clinical Practice Research Datalink Aurum database from April 2016 to March 2023 were included. Monthly GP consultation rates for RTIs from April 2021 to March 2023 were compared with the corresponding months during pre-pandemic years (April 2016 to February 2020).
There were 3 226 285 GP consultations for RTIs among 2 894 539 children. Pre-pandemic, mean monthly consultation rates ranged from lows in August to highs in November (from 2368 to 8682 per 100 000 children, respectively). Following the pandemic lockdowns in 2020, monthly rates in 2021/2022 peaked in June and October at 5152 and 5942 per 100 000 children, respectively, but the winter peak was less marked than pre-pandemic and mean monthly rates were 16.8% lower (95% confidence interval [CI] = - 13.4 to - 19.6). In 2022/2023, after all restrictions were lifted, rates remained around 15% below pre-pandemic years, but the winter peak for children aged 3-4 years was 8615 per 100 000 children, exceeding mean pre-pandemic winter peaks of 6011 per 100 000 children. This was an increase of 43.3% and coincided with a streptococcal group A outbreak. Across all ages there was a sharp increase (from 1486 to 2370 per 100 000 children, around 60%) in tonsillitis, A, and bacterial ear infections.
This study shows reductions in GP consultations for RTIs in children aged <5 years since the lifting of COVID-19 pandemic restrictions. Of concern is a sharp rise in tonsillitis, A, and bacterial ear infections that should be monitored.
自新冠疫情限制措施解除以来，关于儿童呼吸道感染（RTIs）的全科医生（GP）诊疗率如何变化，人们知之甚少。
描述2016年至2023年5岁以下儿童RTIs的全科医生诊疗率变化情况。
一项基于人群的回顾性队列研究，使用来自英格兰各地基层医疗实践的电子健康记录。
纳入2016年4月至2023年3月在临床实践研究数据链奥鲁姆数据库中注册的所有5岁以下儿童。将2021年4月至2023年3月的RTIs月度全科医生诊疗率与疫情前年份（2016年4月至2020年2月）的相应月份进行比较。
2894539名儿童中有3226285次因RTIs进行的全科医生诊疗。疫情前，月度平均诊疗率从8月的低点到11月的高点不等（分别为每10万名儿童2368次至8682次）。2020年疫情封锁后，2021/2022年的月度诊疗率分别在6月和10月达到峰值，每10万名儿童分别为5152次和5942次，但冬季峰值不如疫情前明显，月度平均诊疗率低16.8%（95%置信区间[CI]=-13.4至-19.6）。在2022/2023年，所有限制措施解除后，诊疗率仍比疫情前年份低约15%，但3至4岁儿童的冬季峰值为每10万名儿童8615次，超过了疫情前每10万名儿童6011次的平均冬季峰值。这一增幅为43.3%，与A组链球菌爆发同时出现。在所有年龄段中，扁桃体炎、A组链球菌感染和细菌性耳部感染急剧增加（从每10万名儿童1486次增至2370次，约60%）。
本研究表明，自新冠疫情限制措施解除以来，5岁以下儿童RTIs的全科医生诊疗率有所下降。令人担忧的是，扁桃体炎、A组链球菌感染和细菌性耳部感染急剧上升，应予以监测。
