The impact of COVID-19 pandemic on hospital admissions frequency for LRTIs and viral infections among pediatric patients

ABSTRACT

Background: It has been over a year since the outbreak of the SARS-Cov- 2 pandemic. In response to the rapid escalation of infection cases, many countries from all over the world, including Poland, have introduced measures to limit the transmission of the new coronavirus, from the recommendation of social distancing and wearing masks to strict lockdown. Our aim was to investigate how the SARS-Cov- 2 pandemic has changed the morbidity associated with the most common respiratory viruses and the incidence of lower respiratory tract infections in pediatric population. Method: To achieve the objective of the study, data mining analyzing the electronic health record system of the Children's Hospital of Medical University of Warsaw, one of the two largest pediatric hospitals in the capital of Poland, was conducted. Individual medical records involving LRTI (based on ICD-10 codes) and detection rates for rhinovirus, RSV, influenza, adenovirus, and SARS-CoV- 2 infections were collected and compared between March 2020 to February 2021, and four previous seasons (2016-2020). Results: A total of 5182 medical records of LTRI were obtained, classified into the following categories a) viral infections (including bronchiolitis), b) influenza and flu-like infections, and c) bacterial infections from the last five years. During 2016-2020 seasons the cumulative, as well as segregated, annual admission rates remained steady (mean 1198, ranging from 1081 to 1294). In contrast, this trend was not reflected during the last 2020/2021 season as the total LRTI admission rate sharply and statistically significantly dropped to 468 (p < 0.05). In comparison to the average number of hospitalizations during the 2016-2020 seasons, the reduced hospitalization rates in 2020/2021 in the subgroups of viral infections, bronchiolitis, flu, and bacterial infections accounted for 31% (134/430), 41% (79/193), 65% (76/117), and 27% (179/651) cases, respectively. Conclusion: The results of our study demonstrate a substantial decrease in the hospitalization frequency from March 2020 to February 2021 compared to four previous years. The research illustrates the lockdown and social distancing are not only reflected in the decline of reported SARS-CoV- 2 cases but also in other viral and nonviral respiratory tract infections in children, and shows the effectiveness of restrictions in preventing LRTIs among pediatric patients.