1. In a large cohort of children from China, there was a significant decrease in outpatient visits and respiratory tract infections during the COVID-19 outbreak.
Evidence level rating: 2 (Good)
Children are commonly affected by respiratory tract infections and it has been confirmed that a majority of them are due to viruses such as Adenovirus (ADV), influenza A (FluA), influenza B (FluB), and respiratory syncytial virus. Over the past year, stay-at-home orders, reducing non-essential activities, and wearing of masks amongst other measures have been used to reduce the transmission potential of the novel coronavirus (COVID-19). Interestingly, there is evidence suggesting that these measures have additionally significantly reduced the transmission of other respiratory tract infections. To further investigate this, this cohort study extracted data on outpatient visits, respiratory infection visits, number of completed tests for respiratory viruses, and tested positive cases from electronic health records. The data extracted from January to April, 2020 was compared to the same time period in 2018 and 2019. It found that outpatient visits in January, 2020 were comparable with those in 2019 and 2018 (241,251 vs. 266,190 vs. 315,685 respectively). However, outpatient visits reduced significantly during the period of February-April, 2020 when compared to the same period in 2018 and 2019. Specifically, it reduced by 57.4% (288,003 vs. 676,704) from 2019 and by 59.9% (288,003 vs. 717,983) from 2018. The total number of pediatric respiratory infections from January to April, 2020 was lower than the number in 2018 and 2019. It decreased by 59.0% (119,532 vs. 291,557) when compared to 2019 and by 65.7% (119,532 vs. 348,762) from 2018. The number respiratory tests completed declined significantly from 33,037 in 2018 and 55,103 in 2019 to 7,005 in 2020. Finally, the study also reported that cases positive for ADV, FluA, FluB, and RSV were significantly lower in 2020 when compared to 2018 and 2019. Overall, the study demonstrated a decrease in respiratory infections amongst children during the COVID-19 outbreak. It predicted that this was likely due to blocking transmission routes via frequent handwashing, wearing masks, and isolating by staying at home, and provide interesting insight into how health protective behaviours for COVID-19 have impacted the transmission dynamics of other diseases.
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