Large decrease in paediatric hospitalisations during the COVID-19 outbreak in Japan

Sano, Keisuke; Nakamura, Masaki; Ninomiya, Hideki; Kobayashi, Yasuki; Miyawaki, Atsushi

doi:10.1136/bmjpo-2020-001013

Cited by 9 publications

(11 citation statements)

References 5 publications

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“…The MDV database has been widely used in previous studies. 22 , 23 , 24 , 25 The age distribution of inpatients in the MDV database is roughly similar to that of all DPC hospitals, whereas the hospital volume (i.e., the number of beds) tends to be larger (Supplementary Table 1). Laboratory test values were available for approximately 10% of participating hospitals that agreed to provide the data.…”

Section: Methodsmentioning

confidence: 88%

Comparison of patient characteristics and in-hospital mortality between patients with COVID-19 in 2020 and those with influenza in 2017–2020: a multicenter, retrospective cohort study in Japan

Taniguchi

Kuno

Komiyama

et al. 2022

The Lancet Regional Health - Western Pacific

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Background COVID-19 has worse mortality than influenza in American and European studies, but evidence from the Western Pacific region is scarce. Methods Using a large-scale multicenter inpatient claims data in Japan, we identified individuals hospitalised with COVID-19 in 2020 or influenza in 2017–2020. We compared patient characteristics, supportive care, and in-hospital mortality, with multivariable logistic regression analyses for in-hospital mortality overall, by age group, and among patients with mechanical ventilation. Findings We identified 16,790 COVID-19 patients and 27,870 influenza patients, with the different age distribution (peak at 70–89 years in COVID-19 vs. bimodal peaks at 0–9 and 80–89 years in influenza). On admission, the use of mechanical ventilation was similar in both groups (1·4% vs. 1·4%) but higher in the COVID-19 group (3·3% vs. 2·5%; p<0·0001) during the entire hospitalisation. The crude in-hospital mortality was 5·1% (856/16,790) for COVID-19 and 2·8% (791/27,870) for influenza. Adjusted for potential confounders, the in-hospital mortality was higher for COVID-19 than for influenza (adjusted odds ratio [aOR] 1·83, 95% confidence interval [CI] 1·64–2·04). In age-stratified analyses, the aOR (95%CI) were 0·78 (0·56–1·08) and 2·05 (1·83–2·30) in patients aged 20–69 years and ≥70 years, respectively (p-for-interaction<0·0001). Among patients with mechanical ventilation, the aOR was 0·79 (0·59–1·05). Interpretation Patients hospitalised with COVID-19 in Japan were more likely to die than those with influenza. However, this was mainly driven by findings in older people, and there was no difference once mechanical ventilation was started. Funding Ministry of Health, Labour and Welfare of Japan (21AA2007).

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Section: Methodsmentioning

confidence: 88%

Comparison of patient characteristics and in-hospital mortality between patients with COVID-19 in 2020 and those with influenza in 2017–2020: a multicenter, retrospective cohort study in Japan

Taniguchi

Kuno

Komiyama

et al. 2022

The Lancet Regional Health - Western Pacific

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“…This was in line with other studies reporting similar reductions in children with high triage urgency or need for hospital admission. [6,[30][31][32][33][34][35][36][37][38] Defining the harm of delayed presentations, as well as establishing what contributed to a possible delay, can be difficult. [39] In an attempt to distinguish the delay in seeking care from harm sustained, Roland et al concluded that only a minority (6 out of 51 (11.8%))…”

Section: Discussionmentioning

confidence: 99%

Patterns of presentations of children to emergency departments across Europe and the impact of the COVID-19 pandemic: retrospective observational multinational study

Nijman

Honeyford

Farrugia

et al. 2022

Preprint

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Background To investigate the impact of the COVID-19 pandemic and infection prevention measures on children visiting emergency departments across Europe. Methods Routine health data were extracted retrospectively from electronic patient records of children aged <16 years, presenting to 38 emergency departments (ED) in 16 European countries for the period January 2018 – May 2020, using predefined and standardised data domains. Observed and predicted numbers of ED attendances were calculated for the period February 2020 to May 2020. Poisson models and incidence rate ratios (IRR) were used to compare age groups, diagnoses, and outcomes. Findings Reductions in paediatric ED attendances, hospital admissions and high triage urgencies were seen in all participating sites. ED attendances were relatively higher in countries with lower SARS-CoV-2 prevalence (incidence rate ratio (IRR) 2·62, 95% CI 2·19 to 3·13), and in children aged >12 months (12-<24 months IRR 0·89, 95% CI 0·86 to 0·92; 2-<5years IRR 0·84, 95% CI 0·82 to 0·87; 5-<12 years IRR 0·74, 95% CI 0·72 to 0·76; 12-<16 years IRR 0·74, 95% CI 0·71 to 0·77; vs. age <12 months as reference group). The impact on paediatric intensive care admissions (IRR 1·30, 95% CI 1·16 to 1·45) was not as great as the impact on general admissions. Lower triage urgencies were reduced more than higher triage urgencies (urgent triage IRR 1·10, 95% CI 1·08 to 1·12; emergent and very urgent triage IRR 1·53, 95% CI 1·49 to 1·57; vs. non-urgent triage category). Reductions were highest and sustained throughout the study period for children with communicable infectious diseases. Interpretation Reductions in ED attendances were seen across Europe during the first COVID-19 lockdown period. More severely ill children continued to attend hospital more frequently compared to those with minor injuries and illnesses, although absolute numbers fell.

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“…Several studies have published results showing an increased proportion of complicated cases in the COVID-era [ 2 – 4 , 8 – 10 ]. However, some studies have found only reductions of uncomplicated cases [ 5 , 11 – 16 ] or no change [ 17 ]. Several of these latter studies are registration studies having the advantage of having more data from more centres.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on the incidence of CT-diagnosed appendicitis and its complications in the UK and Sweden

Torkzad¹,

Thorisson

Chabok

et al. 2022

Int J Colorectal Dis

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Aim To compare the number of appendicitis cases and its complications, during the first months of the COVID-19 pandemic in Sweden and the UK and the corresponding time period in 2019. Method Reports of emergency abdominopelvic CT performed at 56 Swedish hospitals and 38 British hospitals between April and July 2020 and a corresponding control cohort from 2019 were reviewed. Two radiologists and two surgeons blinded to the date of cohorts analyzed all reports for diagnosis of appendicitis, perforation, and abscess. A random selection of cases was chosen for the measurement of inter-rater agreement. Result Both in Sweden (6111) and the UK (5591) fewer, abdominopelvic CT scans were done in 2020 compared to 2019 (6433 and 7223, respectively); p < 0.001. In the UK, the number of appendicitis was 36% lower in April–June 2020 compared to 2019 but not in Sweden. Among the appendicitis cases, there was a higher number of perforations and abscesses in 2020, in Sweden. In the UK, the number of perforations and abscesses were initially lower (April–June 2020) but increased in July 2020. There was a substantial inter-rater agreement for the diagnosis of perforations and abscess formations ( K = 0.64 and 0.77). Conclusion In Sweden, the number of appendicitis was not different between 2019 and 2020; however, there was an increase of complications. In the UK, there was a significant decrease of cases in 2020. The prevalence of complications was lower initially but increased in July. These findings suggest variability in delay in diagnosis of appendicitis depending on the country and time frame studied.

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Large decrease in paediatric hospitalisations during the COVID-19 outbreak in Japan

Cited by 9 publications

References 5 publications

Comparison of patient characteristics and in-hospital mortality between patients with COVID-19 in 2020 and those with influenza in 2017–2020: a multicenter, retrospective cohort study in Japan

Comparison of patient characteristics and in-hospital mortality between patients with COVID-19 in 2020 and those with influenza in 2017–2020: a multicenter, retrospective cohort study in Japan

Patterns of presentations of children to emergency departments across Europe and the impact of the COVID-19 pandemic: retrospective observational multinational study

Impact of COVID-19 on the incidence of CT-diagnosed appendicitis and its complications in the UK and Sweden

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