Fall of Community-Acquired Pneumonia in Children following COVID-19 Non-Pharmaceutical Interventions: A Time Series Analysis

Alexis Rybak; David Dawei Yang; Cécile Schrimpf; Romain Guedj; Corinne Levy; Robert Cohen; Vincent Gajdos; Julie Tort; David Skurnik; Naïm Ouldali; François Angoulvant

doi:10.3390/pathogens10111375

Fall of Community-Acquired Pneumonia in Children following COVID-19 Non-Pharmaceutical Interventions: A Time Series Analysis

Pathogens. 2021 Oct 24;10(11):1375. doi: 10.3390/pathogens10111375.

Authors

Alexis Rybak^{1

2

3}, David Dawei Yang⁴, Cécile Schrimpf⁴, Romain Guedj^{5

6}, Corinne Levy^{3

7}, Robert Cohen^{3

7}, Vincent Gajdos^{8

9}, Julie Tort¹⁰, David Skurnik^{11

12

13}, Naïm Ouldali^{2

3

14}, François Angoulvant^{14

15

16}

Affiliations

¹ Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Robert Debré University Hospital, Université de Paris, 75019 Paris, France.
² INSERM UMR 1123, ECEVE, Université de Paris, 75019 Paris, France.
³ ACTIV, Association Clinique et Thérapeutique Infantile du Val-de-Marne, 94000 Créteil, France.
⁴ Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Necker-Enfants Malades University Hospital, Université de Paris, 75015 Paris, France.
⁵ Assistance Publique-Hôpitaux de Paris, Pediatric Emergency Department, Armand Trousseau University Hospital, Sorbonne Université, 75012 Paris, France.
⁶ Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Inserm UMR 1153, Université de Paris, 75004 Paris, France.
⁷ Centre Hospitalier Intercommunal, Research Centre, Université Paris Est, IMRB-GRC GEMINI, 94000 Créteil, France.
⁸ Assistance Publique-Hôpitaux de Paris, Pediatric Department, Antoine Béclère University Hospital, Université de Paris Saclay, 92140 Clamart, France.
⁹ Center for Research in Epidemiology and Population Health, INSERM UMR 1018, 94800 Villejuif, France.
¹⁰ Assistance Publique-Hôpitaux de Paris, Patient Quality Medical Organisation Departement-Health Crisis Management, 75004 Paris, France.
¹¹ Assistance Publique-Hôpitaux de Paris, Department of Clinical Microbiology, Necker-Enfants Malades University Hospital, Université de Paris, 75015 Paris, France.
¹² INSERM U1151-Equipe 1, Institut Necker-Enfants Malades, Université de Paris, 75015 Paris, France.
¹³ Division of Infectious Diseases, Harvard Medical School, Boston, MA 02115, USA.
¹⁴ Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, 75019 Paris, France.
¹⁵ INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, 75006 Paris, France.
¹⁶ Inria, HeKA, Inria, 75006 Paris, France.

Abstract

Non-pharmaceutical interventions (NPIs) were implemented to reduce the spread of coronavirus disease 2019 (COVID-19). A first national lockdown was decided in France on the 17 March 2020. These measures had an impact on other viral and non-viral infectious diseases. We aimed to assess this impact on community-acquired pneumonia (CAP) in children. We performed a quasi-experimental interrupted time series analysis. We used data from a French prospective surveillance system of six pediatric emergency departments (PEDs). All visits from 1 January 2017 to 31 December 2020 were included. Pre-intervention period was before 17 March 2020 and post-intervention period was after 18 March 2020. We estimated the impact on the weekly number of visits for CAP and CAP admission using quasi-Poisson regression modeling. A total of 981,782 PEDs visits were analyzed; among them, 8318 visits were associated with CAP, and 1774 of these were followed by a hospital admission. A major decrease was observed for CAP visits (-79.7% 95% CI [-84.3; -73.8]; p < 0.0001), and CAP admission (-71.3% 95 CI [-78.8; -61.1]; p < 0.0001). We observed a dramatic decrease of CAP in children following NPIs implementation. Further studies are required to assess the long-term impact of these measures.

Keywords: COVID-19; children; community-acquired pneumonia; mitigation measures; non-pharmaceutical interventions; time series analysis.