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Authors
Abstract(s)
Introdução: As infeções respiratórias causam significativa morbimortalidade em
lactentes e crianças, sendo uma das principais razões de procura de serviços de saúde. No
final do ano de 2019, surgiu uma nova estirpe do Coronavírus Humano, altamente
contagiosa, o SARS-CoV-2, que desencadeou a pandemia da COVID-19. Para gerir a
situação epidemiológica, foram implementadas medidas não farmacológicas de contenção
do vírus, que desempenharam um papel fulcral no controlo da pandemia, e também tiveram
impacto na redução de infeções respiratórias pediátricas provocadas por outros agentes.
Após a suspensão dessas medidas, assistiu-se ao retorno das infeções respiratórias,
parecendo estar a sazonalidade habitual alterada.
Objetivos: Avaliar o impacto das medidas não farmacológicas implementadas durante a
pandemia nas infeções respiratórias em idade pediátrica, designadamente o impacto na
procura pelos serviços de urgência por infeções respiratórias, durante e após a pandemia, e
na variabilidade da gravidade da doença, incluindo a possibilidade de surtos
epidemiológicos não sazonais.
Métodos: Estudo observacional transversal de crianças dos 0 aos 10 anos que recorreram
ao serviço de urgência pediátrica do CHUCB, por motivos de infeção respiratória aguda, de
abril de 2019 a abril de 2023. Definiram-se 3 períodos: o período pré-COVID-19 (12 meses),
o período COVID-19 (25 meses) e o período pós-COVID-19 (12 meses); nesses períodos,
foram incluídas as crianças que recorreram ao serviço de urgências nos primeiros 5 dias de
cada mês. A partir do processo clínico, foram recolhidas informações sociodemográficas e
clínicas dos doentes, posteriormente analisadas com recurso ao software SPSS®, versão 28.
Realizou-se a análise descritiva dos dados e utilizaram-se métodos de estatística inferencial,
com um nível de significância de 5%.
Resultados: Durante os dias em que incidiu o estudo, um total de 7448 crianças
recorreram ao serviço de urgência, tendo sido 2210 por motivo de infeção respiratória. No
período pré-COVID-19, das 2538 admissões, 735 foram por infeções respiratórias. No
primeiro ano do período COVID-19, registou-se uma grande diminuição do número de
admissões no serviço de urgências, com 736 admissões, das quais 122 por infeções
respiratórias, e no segundo ano do período COVID-19, o número total de admissões
aumentou para 1862, das quais 559 por infeções respiratórias. No período pós-COVID-19,
das 2312 admissões, 794 foram por infeções respiratórias. É de destacar que a nasofaringite foi a única patologia com aumento significativo no período pós-COVID-19 (n=417), em
comparação com a situação pré-pandémica (n=291). No que diz respeito aos internamentos,
não houve diferenças significativas entre os 3 períodos. Durante a pandemia, verificaramse mudanças na sazonalidade de alguns vírus respiratórios, com picos de infeção
intersazonais.
Conclusão: As intervenções não farmacológicas desempenharam um papel crucial no
controlo da propagação do SARS-CoV-2, como também contribuíram para a prevenção de
outras doenças respiratórias infeciosas. Com o alívio das medidas verificou-se um aumento
de contágios e, bem como o aumento das infeções respiratórias, sem que ocorresse aumento
correspondente na gravidade das doenças/número de internamentos. Para além disso,
associadas à flexibilização das medidas de contenção, ocorreram mudanças na dinâmica de
circulação dos vírus durante a pandemia, com alterações nos padrões sazonais típicos das
infeções respiratórias.
Introduction: Respiratory infections are responsible for significant morbidity and mortality in both infants and children, being one of the main reasons for seeking healthcare services. In the end of the year 2019, a new strain of the Human Coronavirus, highly contagious, emerged, the SARS-CoV-2 and led to the COVID-19 pandemic. To handle the epidemiological situation, non-pharmacological interventions to contain the virus were implemented, playing an important role in controlling the pandemic and also in reducing pediatric respiratory infections caused by other agents. Once these interventions were suspended, there was a return of the respiratory infections, suggesting that the usual seasonality may have been altered. Objectives: To evaluate the impact of the non-pharmacological interventions implemented during the pandemic in pediatric respiratory infections, particularly the impact in the emergency department visits for respiratory infections, during and after the pandemic and in the variability in the severity of the disease, including the possibility of non-seasonal epidemiological outbreaks. Methods: Cross-sectional observational study of children aged 0 to 10 years that were admitted in the CHUCB pediatric emergency department for acute respiratory infection, from April 2019 to April 2023. We defined three periods: the pre-COVID-19 period (12 months), the COVID-19 period (25 months) and the post-COVID-19 period (12 months); in each of these periods, we included children who were admitted in the emergency department in the first 5 days of each month. Demographic and clinical information was collected from the clinical records of the patients and analyzed using SPSS® 28 version software. We conducted a descriptive analysis of the data and used inferential statistical methods, with a significance level of 5%. Results: Considering the days of the study, a total of 7448 children were admitted in the pediatric emergency department, 2210 due to respiratory infection. In the pre-COVID-19 period, from 2538 admissions, 735 were due to respiratory infections. In the first year of the COVID-19 period, there was an important reduction in the number of emergency department admissions, with a total of 736, with 122 due to respiratory infections. In the second year of this period, the total number of admissions raised to 1862, with 559 because of respiratory infections. In the post-COVID-19 period, from 2312 admissions, 794 were due to respiratory infections. It is noteworthy that nasopharyngitis was the only pathology with a significant raise in the post-COVID-19 period (n=417), when comparing to the prepandemic situation (n=291). Regarding hospitalizations, there were not significant differences between the three periods. During the pandemic, there were changes in the seasonality of some respiratory viruses, with inter-seasonal outbreaks of infection. Conclusion: The non-pharmacological interventions played a crucial role in the control of the SARS-CoV-2 spread and contributed to the prevention of other infectious respiratory diseases. The suspension of this interventions led to an increase in contagions and to an increase of respiratory infections, but without a corresponding increase in the severity of the disease or in the number of hospitalizations. Furthermore, associated with the flexibilization of the contention intervention, changes in the dynamic of the viruses circulation occurred during the pandemic, with changes in the typical seasonal patterns of respiratory infections.
Introduction: Respiratory infections are responsible for significant morbidity and mortality in both infants and children, being one of the main reasons for seeking healthcare services. In the end of the year 2019, a new strain of the Human Coronavirus, highly contagious, emerged, the SARS-CoV-2 and led to the COVID-19 pandemic. To handle the epidemiological situation, non-pharmacological interventions to contain the virus were implemented, playing an important role in controlling the pandemic and also in reducing pediatric respiratory infections caused by other agents. Once these interventions were suspended, there was a return of the respiratory infections, suggesting that the usual seasonality may have been altered. Objectives: To evaluate the impact of the non-pharmacological interventions implemented during the pandemic in pediatric respiratory infections, particularly the impact in the emergency department visits for respiratory infections, during and after the pandemic and in the variability in the severity of the disease, including the possibility of non-seasonal epidemiological outbreaks. Methods: Cross-sectional observational study of children aged 0 to 10 years that were admitted in the CHUCB pediatric emergency department for acute respiratory infection, from April 2019 to April 2023. We defined three periods: the pre-COVID-19 period (12 months), the COVID-19 period (25 months) and the post-COVID-19 period (12 months); in each of these periods, we included children who were admitted in the emergency department in the first 5 days of each month. Demographic and clinical information was collected from the clinical records of the patients and analyzed using SPSS® 28 version software. We conducted a descriptive analysis of the data and used inferential statistical methods, with a significance level of 5%. Results: Considering the days of the study, a total of 7448 children were admitted in the pediatric emergency department, 2210 due to respiratory infection. In the pre-COVID-19 period, from 2538 admissions, 735 were due to respiratory infections. In the first year of the COVID-19 period, there was an important reduction in the number of emergency department admissions, with a total of 736, with 122 due to respiratory infections. In the second year of this period, the total number of admissions raised to 1862, with 559 because of respiratory infections. In the post-COVID-19 period, from 2312 admissions, 794 were due to respiratory infections. It is noteworthy that nasopharyngitis was the only pathology with a significant raise in the post-COVID-19 period (n=417), when comparing to the prepandemic situation (n=291). Regarding hospitalizations, there were not significant differences between the three periods. During the pandemic, there were changes in the seasonality of some respiratory viruses, with inter-seasonal outbreaks of infection. Conclusion: The non-pharmacological interventions played a crucial role in the control of the SARS-CoV-2 spread and contributed to the prevention of other infectious respiratory diseases. The suspension of this interventions led to an increase in contagions and to an increase of respiratory infections, but without a corresponding increase in the severity of the disease or in the number of hospitalizations. Furthermore, associated with the flexibilization of the contention intervention, changes in the dynamic of the viruses circulation occurred during the pandemic, with changes in the typical seasonal patterns of respiratory infections.
Description
Keywords
Covid-19 Infeções Respiratórias Intervenções Não Farmacológicas Pandemia Pediatria