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2.
J Med Virol ; 2022 May 16.
Article in English | MEDLINE | ID: covidwho-1844143

ABSTRACT

Social restrictions interrupted the normal respiratory virus circulation in Spring 2020. This report describes virus circulation in the pediatric population before and after the restrictions ended in Finland in September 2021. ​​​​​​We used data from the Finnish Infectious Disease Register. Nationwide influenza A and B, rhinovirus, severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), and respiratory syncytial virus (RSV) findings from January 2018 to December 2021. Age stratified (0-4, 5-9, and 10-14 years) weekly incidences per 100 000 children were calculated. ​School and day-care closures interrupted completely the circulation of all other respiratory viruses than rhinovirus in spring 2020. After restrictions were relaxed in September 2021, SARS-Cov-2 detections increased majorly. We observed high RSV season atypically early. SARS-Cov-2 was detected in older children whereas RSV season peaked especially among children aged under 5. Influenza seemed to return to normal circulation. ​In conclusion, we report that the ending of social restrictions in September 2021 led to an increase in SARS-Cov-2 detections and high epidemic peaks of RSV and parainfluenza in atypical timing in children. Our results highlight the importance of continuous pathogen surveillance during the pandemic, as atypical surges of non-COVID-19 respiratory viruses were observed.

3.
Influenza Other Respir Viruses ; 2022 Apr 27.
Article in English | MEDLINE | ID: covidwho-1807135

ABSTRACT

COVID-19 vaccination effectiveness has been monitored in observational studies (test-negativity design or traditional cohort design), but these studies have not addressed the potential behavioral bias between vaccinated and unvaccinated individuals. We aimed to address this by comparing COVID-19 testing rates between vaccination status and whether vaccination changes the testing rates. We found that three times vaccinated had least tests performed during the pandemic and unvaccinated had the highest testing rate. Each vaccination dose increased the testing rate. In conclusion the observational studies addressing vaccine effectiveness should also present testing rates between vaccinated and unvaccinated to address the potential behavioral bias.

5.
PLoS One ; 17(2): e0263435, 2022.
Article in English | MEDLINE | ID: covidwho-1793529

ABSTRACT

INTRODUCTIONS: The rate of acute hand trauma visits to emergency departments (ED) and surgeries decreased during the COVID-19 lockdown. Our aim was to analyze the influence of national lockdown during the first wave and the regional restrictions during the second wave on the rate of visits to the ED and urgent hand surgeries in Finland. METHODS: Material for this retrospective study was gathered from three Finnish hospitals All ED visits and urgent or emergency surgeries from January 2017 to December 2020 were included. Incidences per 100 000 persons with 95% confidence intervals (CI) were calculated and compared by incidence rate ratios (IRR). RESULTS: The incidence of hand injury was lower after the beginning of the lockdown in March 2020 (IRR 0.70 CI 0.63-0.78). After lockdown ended in May, the monthly incidences of ED visits returned to the reference level. During the lockdown, the incidence of fractures and dislocations was 42% lower in March (IRR 0.58 CI 0.50-0.68) and 33% lower in April 2020 (IRR 0.67 CI 0.57-0.80). The incidence of fracture repair surgeries was 43% lower in March 2020 (IRR 0.57 CI 0.35-0.93) and 41% lower in July 2020 (IRR 0.59 CI 0.36-0.98). Incidence of replantation was 49% higher in March 2020 (IRR 1.49 CI 0.53-4.20) and 200% higher in July 2020 (IRR 3.00 CI 0.68-13.2) but these increases had high uncertainty. CONCLUSIONS: The rate of ED visits due to hand injuries decreased while the rate of emergency hand operations remained unchanged during the national COVID-19 lockdown in spring. After the lockdown, the incidences returned to reference level and were unaffected by regional restrictions during the second wave of pandemic.


Subject(s)
Emergency Medical Services/trends , Hand Injuries/epidemiology , Adult , COVID-19 , Emergency Medical Services/statistics & numerical data , Emergency Service, Hospital , Female , Finland/epidemiology , Hand/surgery , Hand Injuries/surgery , Hospitalization , Hospitals , Humans , Incidence , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2
6.
Influenza Other Respir Viruses ; 16(4): 613-616, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1752579

ABSTRACT

Social restrictions interrupted the circulation of common respiratory viruses among children in spring 2020. In the winter season 2020-2021, only rhinovirus spread in Finland. As the restrictions were ended in September 2021, we saw record high epidemic peak of parainfluenza. Typically, the epidemic peak is in springtime, but now, it started in the early fall 2021. The monthly incidence among children aged 0-4 years (120 per 100,000 children) was six times higher than the second highest reported monthly incidence (21 per 100,000 children) during the last 10 years. Our finding highlights the importance of active surveillance of viral respiratory pathogens during the pandemic.


Subject(s)
COVID-19 , Paramyxoviridae Infections , Respiratory Tract Infections , COVID-19/epidemiology , COVID-19/prevention & control , Child , Finland/epidemiology , Humans , Infant , Paramyxoviridae Infections/epidemiology , Respiratory Tract Infections/epidemiology , Seasons
7.
Acta Orthop ; 93: 360-366, 2022 03 07.
Article in English | MEDLINE | ID: covidwho-1731698

ABSTRACT

BACKGROUND AND PURPOSE: COVID-19 lockdowns have affected personal mobility and behavior worldwide. This study compared the number of emergency department (ED) visits due to injuries and typical low-energy fractures in Finland during the COVID-19 lockdown period in spring 2020 to the reference period in 2019. PATIENTS AND METHODS: The data was collected retrospectively from the electronic patient records of 4 hospitals covering 1/5 of the Finnish population. We included the patients who were admitted to a hospital ED due to any injury during the lockdown period (March 18-May 31, 2020) and the reference period (March 18-May 31, 2019). We compared the differences between the average daily ED admissions in the 2 years using the zero-inflated Poisson regression model. RESULTS: The overall number of ED visits due to injuries decreased by 16% (mean 134/day vs. 113/day, 95% CI -18 to -13). The number of ED visits due to wrist fractures decreased among women aged over 50 years by 40% (CI -59 to -9). Among women, the number of ED visits due to ankle fractures decreased by 32% (CI -52 to -5). The number of ED visits due to fractures of the upper end of the humerus decreased by 52% (CI -71 to -22) among women. The number of ED visits due to hip fractures increased by 2% (CI -16 to 24). INTERPRETATION: Restrictions in personal mobility decreased the number of ED visits due to injuries during the pandemic. The effect can mainly be seen as a decreased number of the most typical low-energy fractures among women. In contrast, lockdown restrictions had no effect on the number of hip fractures.


Subject(s)
COVID-19/epidemiology , Communicable Disease Control/methods , Emergency Service, Hospital/statistics & numerical data , Hip Fractures/epidemiology , Hospitalization/trends , Quarantine , SARS-CoV-2 , Adolescent , Adult , COVID-19/transmission , Comorbidity , Female , Finland/epidemiology , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Pandemics , Retrospective Studies , Young Adult
8.
Eur J Pediatr ; 181(5): 1979-1984, 2022 May.
Article in English | MEDLINE | ID: covidwho-1661694

ABSTRACT

Social restrictions reduced the rates of respiratory infections in 2020, but studies on the rates of urinary tract infections (UTIs) during lockdown have had conflicting results. This study aimed to report UTI incidence during the first and second waves of COVID-19 pandemic in Finland. We conducted a retrospective register-based cohort study. The whole Finnish pediatric population (children under the age of 15 years, N = 860,000) was included. The yearly and monthly incidences of UTIs per 100,000 children in 2020 were compared to that of three previous years (2017-2019) by incidence rate ratios (IRRs) with 95% confidence intervals (CIs). A total of 10,757 cystitis and 4873 pyelonephritis cases were included. The yearly incidence of cystitis was 12% lower (IRR 0.88, CI 0.83-0.94) among children aged 1-6 in 2020 and 11% (IRR 0.89, CI 0.83-0.95) lower among children aged 7-14 in 2020 compared with previous years. The yearly incidence of pyelonephritis was 16% lower (IRR 0.84, CI 0.76-0.94) among children aged 1-6. No significant decrease were observed among children aged < 1 and 7-14. CONCLUSION: The incidence of cystitis and pyelonephritis during a period of social restrictions was lower than during 2017-2019, especially in children aged 1-6 years. These results raise the possibility of reducing the occurrence of urinary tract infections in children by improving hygiene measures. WHAT IS KNOWN: • Social restrictions have reduced the rate of common respiratory infections globally. • Previous studies have presented a decreased or unchanged incidence of urinary tract infections during the COVID-19 pandemic. WHAT IS NEW: • During the pandemic, there was a decrease in the incidence of urinary tract infections in Finnish children and the most prominent decrease was in daycare-aged children. • Improved hygiene measures and social restrictions may have influenced the transmission of uropathogens.


Subject(s)
COVID-19 , Cystitis , Pyelonephritis , Respiratory Tract Infections , Urinary Tract Infections , COVID-19/epidemiology , COVID-19/prevention & control , Child , Cohort Studies , Communicable Disease Control , Cystitis/epidemiology , Female , Finland/epidemiology , Humans , Male , Pandemics , Respiratory Tract Infections/epidemiology , Retrospective Studies , Urinary Tract Infections/epidemiology , Urinary Tract Infections/prevention & control
9.
SN comprehensive clinical medicine ; 4(1), 2022.
Article in English | EuropePMC | ID: covidwho-1615410

ABSTRACT

The concern has been that this prioritization has resulted in age-related inequality between patients, with the older population suffering the most. The aim of this multicenter study was to examine the differences in incidence and waiting times of elective surgeries by age during the SARS-CoV-2 coronavirus disease (COVID-19) pandemic in Finland. Data on elective surgery (88 716 operations) were gathered from three Finnish public hospitals for the years 2017–2020. Surgery incidence and waiting times stratified by age groups (younger than 18, 18 to 49, 50 to 69, and 70 or older) were examined, and the year 2020 was compared to the reference years 2017–2019. The mean annual, monthly, and weekly waiting times were calculated with 95% confidence intervals (CI). The first COVID-19 wave decreased surgery incidence most prominently in patients younger than 18 (incidence rate ratio [IRR] 0.64, CI 0.60–0.68) and 70 or older (IRR 0.68, CI 0.66–0.70). After the first wave, the incidence increased in patients aged 50 to 69 and 70 or older by 22% and 29%, respectively. Among patients younger than 18, the incidence in 2020 was 15% lower. In patients younger than 18, waiting times were at mean of 43% longer in June to December compared to the reference years. In patients aged 18 to 49, 50 to 69, and 70 or older, waiting times increased in May but recovered to normal level during fall 2020. COVID-19 decreased the incidence of surgery and led to increased waiting times. Clearing of the treatment backlog started with older patients which resulted in prolonged waiting times among pediatric patients.

11.
Acta Paediatr ; 111(2): 376-382, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1462733

ABSTRACT

AIM: Nationwide lockdowns and social restrictions during the COVID-19 pandemic have reduced childhood infections. We assessed how many items of systemic antibiotics and asthma medicines were dispensed to children aged 0-12 years in Finland before and during the pandemic and analysed the reimbursement costs. METHODS: The data came from the national Finnish register of reimbursable prescriptions, which is maintained by the country's Social Insurance Institution. It included all prescriptions for antibiotics and asthma medicines dispensed to children aged 0-12 years in 2019 and 2020. Prescription rates per 1000 children were calculated for each quarter and compared using rate ratios and 95% confidence intervals (95% CI). RESULTS: Overall dispensing for antibiotics decreased by 55.3% and was most prominent for macrolides for children aged 0-5 years (59.6%, 95% CI 60.9%-58.2%). Asthma medicines decreased by 19.8%, and the most prominent reduction was in short-acting beta-agonists for children aged 0-5 years (35.2%, 95% CI 36.1%-34.2%). These reduced reimbursement costs by 3.4 million Euros from 2019 to 2020. CONCLUSION: This nationwide study showed that the number of antibiotics and asthma medicines decreased by 59.6% and 19.8% respectively from 2019 to 2020, generating a cost saving of 3.4 million Euros.


Subject(s)
Asthma , COVID-19 , Anti-Bacterial Agents/therapeutic use , Asthma/drug therapy , Asthma/epidemiology , Child , Communicable Disease Control , Drug Prescriptions , Humans , Pandemics , SARS-CoV-2
12.
Scand J Public Health ; 50(1): 117-123, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1398815

ABSTRACT

Aims: This multi-centre study examined the effects of restricted availability of health-care services during the COVID-19 pandemic on treatment of coronary artery disease (CAD) in Finland. Methods: Data on referrals to cardiological units (n=81,008), emergency department (ED) visits (n=10,001) and hospitalisations (n=8654) for CAD were collected from three large Finnish hospitals, and incidences were calculated per 100,000 persons for the years 2017 through 2020. Year 2020 was compared to the reference years 2017-2019 by incidence rate ratios (IRR) with 95% confidence intervals (CI). Results: Referrals to cardiological units decreased after the onset of the pandemic in March to May (IRR=0.83, 95% CI 0.81-0.86). ED visits due to acute coronary syndrome decreased during the first months of the pandemic, with the overall annual incidence 2-14% lower than in the reference years. ED visits due to chronic CAD increased prominently during in April and May compared to the corresponding months in the reference years (IRR=1.49, 95% CI 1.23-1.81 in April; IRR=1.57, 95% CI 1.32-1.89 in May) and remained elevated until the end of 2020, with an increase in annual incidence of 17% (IRR=1.17, 95% CI 1.11-1.24). Conclusions: The first COVID-19 wave decreased ED visits due to acute coronary syndromes and increased those due to chronic CAD. The changes in referral and ED visit incidences during the second wave were rather modest.


Subject(s)
COVID-19 , Coronary Artery Disease , Coronary Artery Disease/epidemiology , Emergency Service, Hospital , Finland/epidemiology , Humans , Pandemics , SARS-CoV-2
13.
Laryngoscope Investig Otolaryngol ; 6(4): 878-884, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1310535

ABSTRACT

OBJECTIVE: To assess the impact of social restrictions due to COVID-19 on the number of tympanostomies and tonsillar surgeries in children. METHODS: Incidences were calculated per 100 000 children for tonsillar surgery and tympanostomies in 2020 and compared to the mean incidence of referral years 2017 to 2019 by incidence rate ratios (IRR) with 95% confidence intervals (CIs). Median waiting times were also compared. RESULTS: Before the lockdown, tonsillar surgery incidence was 33.4/100000 (IRR 1.14, CI 0.76-1.71) in February 2020. After the lockdown began, the incidence of tonsillar surgery was 1.4/100000 (IRR 0.04, CI 0.01-0.15) in April. In June, tonsillar operation incidence started to increase (20.4 per 100 000). The incidence of tympanostomies was 81% lower (IRR 0.19, CI 0.09-0.39) in April 2020 and 61% lower (IRR 0.39, CI 0.22-0.69) in August 2020 than in 2017-2019. These incidence rates remained lower all year (December 2020 IRR 0.13, CI 0.05-0.33). Median waiting time for tonsillar surgery was 3.3 months in 2020 and 1.6 months in 2017 to 2019; P <.001, and for tympanostomies 1.3 months in 2020 and 1.0 months in 2017 to 2019, P <.001. The referral rate to otorhinolaryngology during the severest restrictions was 35% lower in April and May 2020 compared with the reference years. CONCLUSION: This study suggests that the restrictions against COVID-19 reduced the incidence rates of tonsil surgery and tympanostomies in children. Also, the lockdown and cancellations of elective operations in spring 2020 led to increased waiting times. These findings may help in preparing for future pandemics.Level of evidence: Level 3.

14.
PLoS One ; 16(7): e0253875, 2021.
Article in English | MEDLINE | ID: covidwho-1298081

ABSTRACT

BACKGROUND: A concern has been that health care reorganizations during the first COVID-19 wave have led to delays in elective surgeries, resulting in increased complications and even mortality. This multicenter study examined the changes in waiting times of elective surgeries during the COVID-19 pandemic in Finland. METHODS: Data on elective surgery were gathered from three Finnish public hospitals for years 2017-2020. Surgery incidence and waiting times were examined and the year 2020 was compared to the reference years 2017-2019. The mean annual, monthly, and weekly waiting times were calculated with 95% confidence intervals (CI). The most common diagnosis groups were examined separately. FINDINGS: A total of 88 693 surgeries were included during the study period. The mean waiting time in 2020 was 92.6 (CI 91.5-93.8) days, whereas the mean waiting time in the reference years was 85.8 (CI 85.1-86.5) days, resulting in an average 8% increase in waiting times in 2020. Elective procedure incidence decreased rapidly in the onset of the first COVID-19 wave in March 2020 but recovered in May and June, after which the surgery incidence was 22% higher than in the reference years and remained at this level until the end of the year. In May 2020 and thereafter until November, waiting times were longer with monthly increases varying between 7% and 34%. In gastrointestinal and genitourinary diseases and neoplasms, waiting times were longer in 2020. In cardiovascular and musculoskeletal diseases, waiting times were shorter in 2020. CONCLUSION: The health care reorganizations due to the pandemic have increased elective surgery waiting times by as much as one-third, even though the elective surgery rate increased by one-fifth after the lockdown.


Subject(s)
COVID-19/epidemiology , Elective Surgical Procedures/statistics & numerical data , COVID-19/pathology , COVID-19/virology , Finland/epidemiology , Hospitals, Public , Humans , Pandemics , SARS-CoV-2/isolation & purification , Time Factors , Waiting Lists
15.
J Med Virol ; 93(10): 6063-6067, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1296838

ABSTRACT

Social restrictions during the coronavirus disease 2019 pandemic strongly affected the epidemiology of influenza and respiratory syncytial virus (RSV). As rhinovirus seemed to spread despite the restrictions, we aimed to analyze rhinovirus epidemiology in children during the pandemic. This register-based study used data from the Finnish Infectious Disease Register. Nationwide rhinovirus findings from July 2015 to March 2021 were included and stratified by age (0-4, 5-9, and 10-14). Cumulative 14-day incidence per 100000 children was calculated. Four thousand five hundred and seventy six positive rhinovirus findings were included, of which 3788 (82.8%) were among children aged 0-4. The highest recorded incidence was 36.2 among children aged 0-4 in October 2017. The highest recorded incidence during the pandemic period was 13.6 in November 2020. The impact of the restrictions was mostly seen among children aged 0-4 years of age in weeks 14-22 in 2020. The incidence has since remained near reference levels in all age groups. Strict restrictions temporarily interrupted the circulation of rhinovirus in spring 2020. Rhinovirus incidence returned to normal levels soon after the harsh restrictions were lifted. These looser social restrictions prevented RSV and influenza seasons but failed to prevent the spread of rhinovirus.


Subject(s)
Picornaviridae Infections/epidemiology , Picornaviridae Infections/prevention & control , Rhinovirus , Adolescent , Age Factors , COVID-19 , Child , Child, Preschool , Finland/epidemiology , Humans , Infant , Infant, Newborn , Pandemics , Physical Distancing , Respiratory Syncytial Virus, Human , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/prevention & control , Respiratory Tract Infections/virology
17.
Ir J Med Sci ; 2021 Jun 18.
Article in English | MEDLINE | ID: covidwho-1274934

ABSTRACT

BACKGROUND: Social restrictions set due to COVID-19 decreased pediatric emergency department (ED). The aim is to report epidemiology of intoxicated patients in pediatric ED during the first and second waves of COVID-19. METHODS: Data for this retrospective hospital discharge register study was gathered from January 2017 to December 2020. Patients aged <18 and intoxicated were included. Incidences are reported per 10,000 children and compared by incidence rate rations (IRRs) with 95% confidence intervals (CIs). RESULTS: Incidence of ED visit for intoxicated patient was 65 per 10,000 in 2020 and 54 per 10,000 in 2017-2019 (IRR 1.20 CI 0.87-1.68). Incidence was lower during the lockdown compared to reference years (IRR 0.50 CI 0.17-1.44). Peak monthly incidence (12 per 10000) was recorded after lockdown in July 2020 (IRR 2.45 CI 1.01-5.92). DISCUSSION: Based on these results, the lockdown and social restrictions did not decrease heavy alcohol or drug consumption among adolescents in Finland.

18.
J Med Virol ; 93(9): 5626-5629, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1212759

ABSTRACT

The nationwide lockdowns ended influenza seasons rapidly in Northern Hemisphere in Spring 2020. The strategy during the second wave was to minimize the restrictions set for children. Children spread influenza and therefore simultaneous influenza and COVID-19 surges were feared. The aim of this report is to analyze the epidemiology of influenza season 2020-2021 in Finland. Data for this retrospective register-based study were gathered from the National Infectious Disease Register, all laboratory-confirmed influenza cases from August 2017 to March 2021 were included. The positive influenza findings were stratified by age, and incidences per 100 000 persons were calculated. Only 41 influenza A and B cases have been reported in this season from August 2020 to March 2021, which adds up to an incidence of 0.9 per 100 000 person-years. In the three preceding years, the numbers and corresponding incidences from August to March were 12 461 (282 per 100 000 person-years) in 2019-2020, 15 276 (346 per 100 000 person-years) in 2018-2019, and 33 659 (761 per 100 000 person-years) in 2017-2018. Nonpharmaceutical interventions combined with the lockdown measures interrupted the influenza season in Finland in March 2020. Despite looser restrictions, alongside traveling restrictions and facial masks, failing to prevent the spread of the severe acute respiratory syndrome coronavirus 2 virus, these restrictions have proved to be effective against seasonal influenza.


Subject(s)
COVID-19/epidemiology , Influenza, Human/epidemiology , Physical Distancing , SARS-CoV-2 , Seasons , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , COVID-19/virology , Child , Child, Preschool , Female , Finland/epidemiology , Humans , Incidence , Infant , Infant, Newborn , Influenza, Human/virology , Male , Middle Aged , Public Health Surveillance , Registries , Retrospective Studies , Young Adult
20.
EClinicalMedicine ; 34: 100807, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1157254

ABSTRACT

BACKGROUND: Nationwide restrictions started in Finland in March to prevent the spread of COVID-19, leading to school and day care closures. The aim of this study is to describe the effect of closures and re-openings on the respiratory pathogen epidemiology. METHODS: Laboratory-confirmed cases of SARS-CoV-2; respiratory syncytial virus (RSV); influenza (A & B); parainfluenza-, adeno-, and rhinoviruses; Mycoplasma pneumoniae; and Streptococcus pneumoniae in children were collected from the National Infectious Disease Register over the period of 2017-2020. Weekly incidences (weeks 1 to 35) with 95% confidence intervals (CIs) were calculated per 100 000 children in 2020 and compared by incidence rate ratios (IRRs) to corresponding periods in 2017-2019. FINDINGS: The lockdown had immediate impact on the incidences of respiratory pathogens except SARS-CoV-2. Week after the lockdown began IRR was 0•3 (CI 0•3-0•4) and next week the IRR was 0•1 (0•1-0•2). The incidence of SARS-CoV-2 started to decline eight weeks after the lockdown began. The highest recorded weekly incidence of SARS-CoV-2 was 7•2/100 000 children. The effect of the lockdown lasted until late summer. Rhinovirus and SARS-CoV-2 began to increase before the schools or day cares opened in August. The re-opening of schools seemed to have no impact on the incidence of any pathogen. INTERPRETATION: Our results suggest that general social distancing, including school and day care closures, played a crucial role in reducing infections, and the effect lasted for several weeks. The re-opening of schools and day care centres seems to have had no immediate impact on the incidences of any respiratory pathogens. FUNDING: This study had no funding source.

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