Impact of COVID-19 Related Restrictions on Infections in Children with Cancer or after Hematopoietic SCT

TY - JOUR

T1 - Impact of COVID-19 Related Restrictions on Infections in Children with Cancer or after Hematopoietic SCT

T2 - A Monocentric, Retrospective Study

AU - Hauch, Richard

AU - Hinrichs, Malena

AU - Ruhwald, Rebecca

AU - Schrum, Johanna

AU - Rutkowski, Stefan

AU - Woessmann, Wilhelm

AU - Winkler, Beate

N1 - Thieme. All rights reserved.

PY - 2023/5

Y1 - 2023/5

N2 - Background Infections are a major concern for immunocompromised children. We investigated whether non-pharmaceutical interventions (NPIs) implemented in the general population during the coronavirus disease 2019 (COVID-19) pandemic in Germany had an impact on frequency, type and severity of infections in these patients.Patients and methods We analyzed all admissions to the clinic of pediatric hematology, oncology and stem cell transplantation (SCT) with (suspected) infection or fever of unknown origin (FUO) from 2018 to 2021.Results We compared a 27-month period before NPIs (Pre-COVID: 01/2018–03/2020; 1041 cases) with a 12-month period with underlying NPIs (COVID: 04/2020–03/2021; 420 cases). During the COVID period the number of in-patient stays with FUO or infections decreased (38,6 cases/month vs. 35,0 cases/month), the median duration of hospital stays was longer (8 d (CI95: 7–8 d) vs. 9 d (CI95: 8–10 d) P=0,02)), the mean number of antibiotics per case increased (2,1 (CI95: 2,0–2,2) vs. 2,5 (CI95: 2,3–2,7); P=0,003)) and a substantial reduction of viral respiratory and gastrointestinal infections per case was seen (0,24 vs. 0,13; P<0,001). Notably, there was no detection of respiratory syncytial virus, influenza and norovirus, between May 2020 and March 2021. Based on need of intensive care measures and further parameters we conclude that severe (bacterial) infections were not significantly reduced by NPIs.Conclusions Introduction of NPIs in the general population during the COVID-pandemic substantially reduced viral respiratory and gastrointestinal infections in immunocompromised patients, while severe (bacterial) infections were not prevented.

AB - Background Infections are a major concern for immunocompromised children. We investigated whether non-pharmaceutical interventions (NPIs) implemented in the general population during the coronavirus disease 2019 (COVID-19) pandemic in Germany had an impact on frequency, type and severity of infections in these patients.Patients and methods We analyzed all admissions to the clinic of pediatric hematology, oncology and stem cell transplantation (SCT) with (suspected) infection or fever of unknown origin (FUO) from 2018 to 2021.Results We compared a 27-month period before NPIs (Pre-COVID: 01/2018–03/2020; 1041 cases) with a 12-month period with underlying NPIs (COVID: 04/2020–03/2021; 420 cases). During the COVID period the number of in-patient stays with FUO or infections decreased (38,6 cases/month vs. 35,0 cases/month), the median duration of hospital stays was longer (8 d (CI95: 7–8 d) vs. 9 d (CI95: 8–10 d) P=0,02)), the mean number of antibiotics per case increased (2,1 (CI95: 2,0–2,2) vs. 2,5 (CI95: 2,3–2,7); P=0,003)) and a substantial reduction of viral respiratory and gastrointestinal infections per case was seen (0,24 vs. 0,13; P<0,001). Notably, there was no detection of respiratory syncytial virus, influenza and norovirus, between May 2020 and March 2021. Based on need of intensive care measures and further parameters we conclude that severe (bacterial) infections were not significantly reduced by NPIs.Conclusions Introduction of NPIs in the general population during the COVID-pandemic substantially reduced viral respiratory and gastrointestinal infections in immunocompromised patients, while severe (bacterial) infections were not prevented.

KW - Humans

KW - Child

KW - COVID-19/epidemiology

KW - Neoplasms/epidemiology

KW - Hematopoietic Stem Cell Transplantation

KW - Medical Oncology

KW - Ambulatory Care Facilities

KW - Respiratory Tract Infections/epidemiology

U2 - 10.1055/a-2000-5388

DO - 10.1055/a-2000-5388

M3 - SCORING: Journal article

C2 - 36848939

VL - 235

SP - 159

EP - 166

JO - KLIN PADIATR

JF - KLIN PADIATR

SN - 0300-8630

IS - 3

ER -