TY - JOUR

T1 - Consequences of COVID-19–related lockdowns and reopenings on emergency hospitalizations in pediatric patients in Denmark during 2020–2021

AU - Al-Jwadi, Rada Faris

AU - Mills, Elisabeth Helen Anna

AU - Torp-Pedersen, Christian

AU - Andersen, Mikkel Porsborg

AU - Jørgensen, Inger Merete

N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

PY - 2023

Y1 - 2023

N2 - There is a considerable burden of children being hospitalized due to infectious diseases worldwide. The COVID-19 pandemic provided a unique opportunity to examine effects of worldwide efforts to control spread of infection. We aimed to investigate overall age-specific hospitalizations due to viral and bacterial infections and diseases triggered by respiratory tract infections during and after lockdown. This nationwide register–based observational study included children from 29 days to 17 years old hospitalized in all Danish pediatric emergency departments during the years 2015–2021. Main outcomes were ICD-10 diagnoses for infectious diseases and infection triggered illnesses. Fluctuations in hospitalization events were explored using figures with weekly events per 100,000. Total events followed a predictable pattern during 2015–2019. In 2020–2021, there was a drop in hospital encounters after lockdowns and surge after reopenings. In 2021, there was a surge of hospital encounters in the late summer due to respiratory syncytial virus infections and asthmatic bronchitis mostly in infants from 29 days to 2 years. For the infectious diseases, there was a dramatic decrease in events after lockdowns and immediate increase in cases that followed the same pattern of previous years after reopenings. Bacterial infections, like urinary tract infections, sepsis, and meningitis followed a steady pattern throughout all calendar-years. Conclusions: Nationwide efforts to minimize infectious disease spread like lockdowns have a preventative and period lasting effect but reopenings/reunions result in surges of infectious diseases. This might be due to children not getting immunized steadily thereby increasing the pool of possible hosts for potential viral infections. What is Known:• There is a seasonal fluctuation in viral/respiratory infections in children with higher infection rates in the winter and lower rates in the summer.• RSV infection is a major source of concern.What is New:• Major lockdowns and reopenings disrupt the seasonal fluctuations which can result in high surges in infections that increases the burden of children emergency departments and the risk of serious complications.

AB - There is a considerable burden of children being hospitalized due to infectious diseases worldwide. The COVID-19 pandemic provided a unique opportunity to examine effects of worldwide efforts to control spread of infection. We aimed to investigate overall age-specific hospitalizations due to viral and bacterial infections and diseases triggered by respiratory tract infections during and after lockdown. This nationwide register–based observational study included children from 29 days to 17 years old hospitalized in all Danish pediatric emergency departments during the years 2015–2021. Main outcomes were ICD-10 diagnoses for infectious diseases and infection triggered illnesses. Fluctuations in hospitalization events were explored using figures with weekly events per 100,000. Total events followed a predictable pattern during 2015–2019. In 2020–2021, there was a drop in hospital encounters after lockdowns and surge after reopenings. In 2021, there was a surge of hospital encounters in the late summer due to respiratory syncytial virus infections and asthmatic bronchitis mostly in infants from 29 days to 2 years. For the infectious diseases, there was a dramatic decrease in events after lockdowns and immediate increase in cases that followed the same pattern of previous years after reopenings. Bacterial infections, like urinary tract infections, sepsis, and meningitis followed a steady pattern throughout all calendar-years. Conclusions: Nationwide efforts to minimize infectious disease spread like lockdowns have a preventative and period lasting effect but reopenings/reunions result in surges of infectious diseases. This might be due to children not getting immunized steadily thereby increasing the pool of possible hosts for potential viral infections. What is Known:• There is a seasonal fluctuation in viral/respiratory infections in children with higher infection rates in the winter and lower rates in the summer.• RSV infection is a major source of concern.What is New:• Major lockdowns and reopenings disrupt the seasonal fluctuations which can result in high surges in infections that increases the burden of children emergency departments and the risk of serious complications.

KW - Children

KW - Coronavirus disease

KW - Pandemic

KW - Respiratory syncytial virus

KW - Seasons

KW - Viral infections

U2 - 10.1007/s00431-022-04682-7

DO - 10.1007/s00431-022-04682-7

M3 - Journal article

C2 - 36331619

AN - SCOPUS:85145977125

VL - 182

SP - 285

EP - 293

JO - Acta Paediatrica Hungarica

JF - Acta Paediatrica Hungarica

SN - 0340-6199

ER -