AUTHOR=Kaur Ravinder , Schulz Steven , Fuji Naoko , Pichichero Michael 

TITLE=COVID-19 Pandemic Impact on Respiratory Infectious Diseases in Primary Care Practice in Children

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 9 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.722483

DOI=10.3389/fped.2021.722483

ISSN=2296-2360

ABSTRACT=Background
The coronavirus 2019 (COVID-19) pandemic led to day care and school closures and children staying home for several months. When they gradually returned, aggressive regulations were implemented in New York State to reduce viral transmission. 

Method
An ongoing prospective study occurring in the Rochester NY region focused on early childhood respiratory infectious diseases, afforded an opportunity to assess the impact of the pandemic on the incidence of these illnesses in a primary care outpatient setting. Physician-diagnosed, medically-attended infection visits were assessed in two child cohorts, age 6-36 months old: from March 15 to December 31, 2020 (the pandemic period) compared to the same months in 2019 (pre-pandemic). Nasopharyngeal colonization by potential otopathogens during health and acute otitis media (AOM) visits was evaluated.

Results 
144 children were included in the pandemic and 215 in the pre-pandemic cohort. The pandemic cohort of children experienced 1.8-fold less frequent infectious disease visits during the pandemic (p<0.0001).  Specifically, visits for AOM were 3.7-fold lower (p <0.0001); viral upper respiratory infections (URI) 3.8-fold lower (p <0.0001); croup 27.5-fold lower (p <0.0001) and bronchiolitis 7.4-fold lower (p =0.04) than the pre-pandemic cohort).  Streptococcus pneumoniae (p =0.03), Haemophilus influenzae (p <0.0001) and Moraxella catarrhalis (p <0.0001) nasopharyngeal colonization occurred less frequently among children during the pandemic.

Conclusion
In primary care pediatric practice, during the first 9 months of the Covid-19 pandemic significant decreases in frequency of multiple respiratory infections and nasopharyngeal colonization by potential bacterial respiratory pathogens occurred in children age 6 to 36 months old.