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How Covid-19 changed the epidemiology of febrile urinary tract infections in children in the emergency department during the first outbreak.
Cesca, Laura; Conversano, Ester; Vianello, Federica Alessandra; Martelli, Laura; Gualeni, Chiara; Bassani, Francesca; Brugnara, Milena; Rubin, Giulia; Parolin, Mattia; Anselmi, Mauro; Marchiori, Mara; Vergine, Gianluca; Miorin, Elisabetta; Vidal, Enrico; Milocco, Cristina; Orsi, Cecilia; Puccio, Giuseppe; Peruzzi, Licia; Montini, Giovanni; Dall'Amico, Roberto.
  • Cesca L; Pediatria - Ospedale Civile S. Maria Degli Angeli Di Pordenone, Pordenone, Italy.
  • Conversano E; Pediatric Department, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy. esterconversano@gmail.com.
  • Vianello FA; Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy.
  • Martelli L; Dipartimento Di Pediatria, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
  • Gualeni C; Clinica Pediatrica Degli Spedali Civili Di Brescia, Brescia, Italy.
  • Bassani F; Unita' Operativa Complessa Di Pediatria, Ospedale Regionale Di Bolzano, Bolzano, Italy.
  • Brugnara M; Pediatria, Ospedale Universitario Della Donna E del Bambino Di Verona, Verona, Italy.
  • Rubin G; Unità Operativa Complessa Di Pediatria, Dipartimento Strutturale Materno-Infantile, Ospedale San Bortolo, Vicenza, Italy.
  • Parolin M; Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, University-Hospital, Padua, Italy.
  • Anselmi M; Unità Operativa Complessa Di Pediatria Dolo-Mirano, Dolo, Italy.
  • Marchiori M; Unità Operativa Complessa Di Pediatria E Patologia Neonatale, Ospedale Dell'Angelo Di Mestre, Mestre, Italy.
  • Vergine G; Department of Pediatrics, Rimini Infermi Hospital, Rimini, Italy.
  • Miorin E; Struttura Complessa Di Pediatria, Ospedale Civile Di Latisana-Palmanova, Latisana, Italy.
  • Vidal E; Division of Pediatrics, Department of Medicine (DAME), University-Hospital of Udine, Udine, Italy.
  • Milocco C; Divisione Di Struttura Operativa Complessa Di Pediatria, Ospedale San Polo, Monfalcone, Italy.
  • Orsi C; Nefrologia Pediatrica - Ospedale Regina Margherita - Città Della Salute E Della Scienza Di Torino, Torino, Italy.
  • Puccio G; Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy.
  • Peruzzi L; Nefrologia Pediatrica - Ospedale Regina Margherita - Città Della Salute E Della Scienza Di Torino, Torino, Italy.
  • Montini G; Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy.
  • Dall'Amico R; Giuliana and Bernardo Caprotti Chair of Pediatrics, Department of Clinical Sciences and Community Health, University of Milano, Milano, Italy.
BMC Pediatr ; 22(1): 550, 2022 09 15.
Article in English | MEDLINE | ID: covidwho-2029697
ABSTRACT

BACKGROUND:

The first Covid-19 pandemic affected the epidemiology of several diseases. A general reduction in the emergency department (ED) accesses was observed during this period, both in adult and pediatric contexts.

METHODS:

This retrospective study was conducted on the behalf of the Italian Society of Pediatric Nephrology (SINePe) in 17 Italian pediatric EDs in March and April 2020, comparing them with data from the same periods in 2018 and 2019. The total number of pediatric (age 0-18 years) ED visits, the number of febrile urinary tract infection (UTI) diagnoses, and clinical and laboratory parameters were retrospectively collected.

RESULTS:

The total number of febrile UTI diagnoses was 339 (73 in 2020, 140 in 2019, and 126 in 2018). During the first Covid-19 pandemic, the total number of ED visits decreased by 75.1%, the total number of febrile UTI diagnoses by 45.1%, with an increase in the UTI diagnosis rate (+ 121.7%). The data collected revealed an increased rate of patients with two or more days of fever before admission (p = 0.02), a significant increase in hospitalization rate (+ 17.5%, p = 0.008) and also in values of C reactive protein (CRP) (p = 0.006). In 2020, intravenous antibiotics use was significantly higher than in 2018 and 2019 (+ 15%, p = 0.025). Urine cultures showed higher Pseudomonas aeruginosa and Enterococcus faecalis percentages and lower rates of Escherichia coli (p = 0.02).

CONCLUSIONS:

The first wave of the Covid-19 pandemic had an essential impact on managing febrile UTIs in the ED, causing an absolute reduction of cases referring to the ED but with higher clinical severity. Children with febrile UTI were more severely ill than the previous two years, probably due to delayed access caused by the fear of potential hospital-acquired Sars-Cov-2 infection. The possible increase in consequent kidney scarring in this population should be considered.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urinary Tract Infections / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Infant, Newborn Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03516-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Urinary Tract Infections / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study Limits: Adolescent / Adult / Child / Child, preschool / Humans / Infant / Infant, Newborn Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03516-7