ABSTRACT
BACKGROUND: To tackle the COVID-19 pandemic and mitigate viral transmission, mainland China has implemented various disease prevention measures and arrangements. We hypothesize that these measures may be pose challenges to the management of pediatric asthma. Here, we studied the situation of pediatric asthma in Chengdu during the COVID-19 pandemic and compared the pediatric asthma situation before so as to provide a reference for designing effective management plan for pediatric asthma patients in the future facing the outbreak of epidemic. METHODS: An observational study was done to compare the pediatric asthma situation in Chengdu from 2017 to 2019 to the situation under COVID-19 pandemic. Asthma incidence, severe asthma attack, air quality, temperature, and patient follow-up were examined. RESULTS: The number of monthly asthma cases decreased significantly in February 2020. The number of asthma cases in 2017-2019 positively correlated with levels of particulate matter PM 2.5 (p = 0.006) and PM10 (p = 0.005), while it negatively correlated with temperature (p = 0.048). No correlation was identified in 2020. A higher rate of severe asthma attack cases (9.69%) was observed among asthma patients in 2020 (p = 0.014). Differences were identified between the monthly severe asthma attack during the period 2017-2020 (p<0.001). The rate of severe asthma attack cases peaked in June and September 2020. The percentage of patients who failed to undergo pulmonary function tests was 34.5% in 2020, remarkably higher than in the previous 3 years (p<0.001). CONCLUSION: The situation and management of pediatric asthma during the 2020 COVID-19 pandemic differed from those in previous years, with more emphasis placed on disease prevention practices and facilities. To design future pediatric asthma management practice, the environmental and psychological impact on asthma management should also be considered. Local areas should make good use of telemedicine to manage pediatric asthma effectively.
ABSTRACT
BACKGROUND: Respiratory tract infection (RTIs) is one of common diseases among the children. In recent years, the incidence of mycoplasma pneumoniae (M. pneumoniae) infection rate has been increasing, which cause respiratory tract infection. This study sought to analyze the epidemiological characteristics of M. pneumoniae hospitalized children with RTIs to provide a theoretical basis for clinical diagnosis and treatments in Chengdu, China. METHODS: The data of 22,882 cases of children who had been hospitalized for RTIs were collected. M. pneumoniae immunoglobulin M (IgM) antibody was detected using the indirect immunofluorescence method and passive agglutination method. The demographic features of patients, clinical diagnoses and laboratory data were also analyzed. RESULTS: A total of 4,213 children tested positive for M. pneumoniae. The total positive rate was 18.41% (18.30% for males and 22.72% for females). Female children had statistically significant higher positive rates than male children (χ2=198.078, P<0.01). The positive rates of M. pneumoniae differed significantly among children of different ages (F=162.7532, P<0.01). The incidence rate of M. pneumoniae in 2017 and 2019 was significantly higher than the average (F=538.95, P<0.01). There were higher M. pneumoniae positive rates from April to May, and September to October (P<0.05) in 2016, 2017, 2018, and 2019. There was no correlation between M. pneumoniae infection and temperature and humidity (P>0.05). There was negative correlation with PM2.5 (particulate matter in the air <2.5 µm) (R=-0.293, P<0.01) and PM10 (particulate matter in the air <10 µm). (R=-0.285, P<0.01). There were significant differences in the constituent ratios of cases of M. pneumoniae infection between in 2020 and other years (F=159.35, P<0.01). Bronchopneumonia accounted for the highest proportion of cases, followed by acute bronchitis and the exacerbation of asthma in 2020. CONCLUSIONS: The epidemiological distribution of M. pneumoniae in children with RTIs in Chengdu was found to be related to gender, age, year and month; however, no relationship was found to temperature and humidity. There was a higher M. pneumoniae positive rate in children with bronchial pneumonia and asthma in cases. The prevention measures used to control Coronavirus Disease 2019 (COVID-19) also effectively controlled the M. pneumoniae infection rate.