Dataset Information

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

ABSTRACT: Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3 yr olds) in July 2021. Influenza remained suppressed throughout. A higher paediatric early warning score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p = 0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.

SUBMITTER: Lumley SF

PROVIDER: S-EPMC8591975 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

Lumley Sheila F SF Richens Nicholas N Lees Emily E Cregan Jack J Kalimeris Elizabeth E Oakley Sarah S Morgan Marcus M Segal Shelley S Dawson Moya M Walker A Sarah AS Eyre David W DW Crook Derrick W DW Beer Sally S Novak Alex A Stoesser Nicole E NE Matthews Philippa C PC

The Journal of infection 20211029 1

Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detectio ...[more]

PMID: 34757137

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Project description:BackgroundWe hypothesised that the clinical characteristics of hospitalised children and young people (CYP) with SARS-CoV-2 in the UK second wave (W2) would differ from the first wave (W1) due to the alpha variant (B.1.1.7), school reopening and relaxation of shielding.MethodsProspective multicentre observational cohort study of patients <19 years hospitalised in the UK with SARS-CoV-2 between 17/01/20 and 31/01/21. Clinical characteristics were compared between W1 and W2 (W1 = 17/01/20-31/07/20,W2 = 01/08/20-31/01/21).Results2044 CYP < 19 years from 187 hospitals. 427/2044 (20.6%) with asymptomatic/incidental SARS-CoV-2 were excluded from main analysis. 16.0% (248/1548) of symptomatic CYP were admitted to critical care and 0.8% (12/1504) died. 5.6% (91/1617) of symptomatic CYP had Multisystem Inflammatory Syndrome in Children (MIS-C). After excluding CYP with MIS-C, patients in W2 had lower Paediatric Early Warning Scores (PEWS, composite vital sign score), lower antibiotic use and less respiratory and cardiovascular support than W1. The proportion of CYP admitted to critical care was unchanged. 58.0% (938/1617) of symptomatic CYP had no reported comorbidity. Patients without co-morbidities were younger (42.4%, 398/938, <1 year), had lower PEWS, shorter length of stay and less respiratory support.ConclusionsWe found no evidence of increased disease severity in W2 vs W1. A large proportion of hospitalised CYP had no comorbidity.ImpactNo evidence of increased severity of COVID-19 admissions amongst children and young people (CYP) in the second vs first wave in the UK, despite changes in variant, relaxation of shielding and return to face-to-face schooling. CYP with no comorbidities made up a significant proportion of those admitted. However, they had shorter length of stays and lower treatment requirements than CYP with comorbidities once those with MIS-C were excluded. At least 20% of CYP admitted in this cohort had asymptomatic/incidental SARS-CoV-2 infection. This paper was presented to SAGE to inform CYP vaccination policy in the UK.

Project description:IntroductionRespiratory tract infections (RTIs) are a leading cause of morbidity and mortality in children worldwide. Aetiologic virus and bacteria vary geographically. To date, no systematic data on RTI aetiologies have been published from Kyrgyzstan, a country with a high under-five mortality from lower RTIs and a widespread overuse of antibiotics. We aimed to identify the aetiologies of RTI in children in Kyrgyzstan and to assess the pneumococcal conjugate vaccine (PCV) vaccination rate and the correlation with the detection of Streptococcus pneumoniae in our population.MethodsWe collected samples from children aged 6 months to 12 years presenting with symptoms of acute RTI for outpatients or diagnosed with pneumonia for inpatients. Samples were collected from November 2022 to June 2023 and were analysed using standard culture methods and real-time polymerase chain reaction (RT-PCR) to identify bacterial, viral, and atypical bacterial pathogens. We obtained the vaccination status through vaccination records and parents' recollections.ResultsPositive bacteriologic cultures were found for 294 (25.0%) of 1174 outpatients and 83 (27.7%) of 300 inpatients. S. pneumoniae was the most commonly found bacterial pathogen in both groups, making up 44.8% of all cultured bacteria. Furthermore, 445 (64.1%) of 694 outpatients with RT-PCR performed had one or more viral pathogens identified, while this was the case for 162 (54.7%) of 296 inpatients. Mycoplasma pneumoniae was identified in 15.8% of inpatients possibly representing an epidemic in the spring of 2023. Approximately 20% of both in- and outpatients had a viral-bacterial simultaneous detection. 87.1% of outpatients and 75.9% of inpatients had been vaccinated with PCV. We found a higher proportion of unvaccinated children among those under five years of age and a higher carriage rate of S. pneumoniae among unvaccinated inpatients.ConclusionIn this study, we found a high prevalence of viral infections and viral-bacterial simultaneous detections among Kyrgyz children with respiratory tract infections (RTI). The findings from this study can inform new clinical guidelines for local health workers and lead to more targeted use of antibiotics and improved health outcomes for children in Kyrgyzstan.Clinical trialNot applicable.

Project description:BackgroundThe COVID-19 pandemic has posed a huge challenge to healthcare systems and their personnel worldwide. The study of the impact of SARS-CoV-2 infection among healthcare workers (HCW), through prevalence studies, will let us know viral expansion, individuals at most risk and the most exposed areas in healthcare organizations. The aim of this study is to gauge the impact of SARS-CoV-2 pandemic in our hospital workforce and identify groups and areas at increased risk.Methods and findingsThis is a cross-sectional and incidence study carried out on healthcare workers based on molecular and serological diagnosis of SARS-CoV-2 infection. Of the 3013 HCW invited to participate, 2439 (80.9%) were recruited, including 674 (22.4%) who had previously consulted at the Occupational Health Service (OHS) for confirmed exposure and/or presenting symptoms suggestive of COVID-19. A total of 411 (16.9%) and 264 (10.8%) healthcare workers were SARS-CoV-2 IgG and rRT-PCR positive, respectively. The cumulative prevalence considering all studies (IgG positive HCW and/or rRT-PCR positive detection) was 485 (19.9%). SARS-CoV-2 IgG-positive patients in whom the virus was not detected were 221 (9.1%); up to 151 of them (68.3%) did not report any compatible symptoms nor consult at the OHS for this reason. Men became more infected than women (25% vs 18.5%, p = 0.0009), including when data were also classified by age. COVID-19 cumulative prevalence among the HCW assigned to medical departments was higher (25.2%) than others, as well as among medical staff (25.4%) compared with other professional categories (p<0.01).ConclusionsThe global impact of the COVID-19 pandemic on HCW of our centre has been 19.9%. Doctors and medical services personnel have had the highest prevalence of SARS-CoV-2 infection, but many of them have not presented compatible symptoms. This emphasizes the performance of continuous surveillance methods of the most exposed health personnel and not only based on the appearance of symptoms.

Dataset Information

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

Publications

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic.

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