Decreased Incidence of Pediatric Intussusception during COVID-19

Abstract

Coronavirus disease 2019 (COVID-19) changed the epidemiology of various diseases. The present study retrospectively investigates the epidemiologic and clinical changes in pediatric intussusception for ages ≤ 7 years before (February 2019–January 2020) and after (February 2020–January 2021) the COVID-19 outbreak in a single pediatric emergency department of a university-affiliated tertiary hospital. The incidence of communicable diseases—defined as infectious diseases with the potential for human-to-human transmission via all methods, non-communicable diseases, and intussusception were decreased following the COVID-19 outbreak (15,932 to 3880 (24.4%), 12,994 to 8050 (62.0%), and 87 to 27 (31.0%), respectively). The incidence of intussusception correlated significantly with the change in incidence of communicable diseases (Poisson log-linear regression, odds ratio = 2.15, 95% CI = 1.08–4.26, and p = 0.029). Compared with the pre-pandemic period, patients of the pandemic period showed higher proportions of pathologic leading point (PLP) and hospitalization (14.8% vs. 2.3% and 18.5% vs. 4.6%, respectively), lower base excesses (−4.8 mmol/L vs. −3.6 mmol/L), and higher lactate concentrations (1.7 mmol/L vs. 1.5 mmol/L). The incidence of pediatric intussusception decreased after the COVID-19 pandemic. This reduced incidence may be related to the reduced incidence of communicable diseases. However, the proportions of more severe diseases and PLPs were higher after the COVID-19 pandemic.

Impact of the COVID-19 Pandemic on Emergency Care Utilization and Outcomes in Pediatric Patients with Intussusception

“…As infection prevention practices are emphasized and recommended during the COVID-19 pandemic, it could be presumed that the incidence of intussusception has also decreased because other viral infections in children have decreased. This interpretation is supported by a study by Park et al, who reported that a decrease in ED visits for communicable diseases was more pronounced than a decrease in visits for noncommunicable diseases, and the former was significantly correlated with the decrease in visits of intussusception [ 13 ]. Children with intussusception may not have visited the ED because their parents were reluctant to visit the hospital.…”

“…On the other hand, there have been few reports of intussusceptions in pediatric patients. In a study using data from one pediatric emergency center in Korea, it was reported that the number of intussusception patients visiting the emergency department decreased at the same time as infectious diseases after the COVID-19 epidemic [ 13 ]. In most cases, the cause of intussusception in children is idiopathic; however, it may be caused by lymphoid hyperplasia due to a viral infection [ 14 ].…”

Development and Validation of a Nomogram for Predicting Pathological Intussusceptions in Children Prior to Surgical Intervention

“…Lee et al ( 29 ) reported that a history of infection was significantly more common in non-recurrent (72/114, 63.2%) than recurrent (5/23, 21.7%) intussusceptions ( P < 0.001). Park et al ( 30 ) found that the incidence of pediatric intussusceptions decreased after the COVID-19 pandemic. That decreased incidence may be related to the reduced circulation of communicable diseases.…”

SARS-CoV-2-assoziierte abdominelle Komplikation bei einem 2 Monate alten Säugling

“…Die Inzidenz pädiatrischer Invaginationen scheint während der COVID-19(„coronavirus disease 2019“)-Pandemie eher abgenommen zu haben [ 1 ]. Nichtdestotrotz mehren sich Berichte einzelner SARS-CoV-2-assoziierter Invaginationen weltweit.…”