AUTHOR=Rybak Alexis , Ouldali Naïm , Angoulvant François , Minodier Philippe , Biscardi Sandra , Madhi Fouad , Hau Isabelle , Santos Audrey , Bouvy Emilie , Dubos François , Martinot Alain , Dommergues Marie-Aliette , Gras-Le Guen Christèle , Launay Elise , Levieux Karine , Zenkhri Ferielle , Craiu Irina , Lorrot Mathie , Gillet Yves , Mezgueldi Ellia , Faye Albert , Béchet Stéphane , Varon Emmanuelle , Cohen Robert , Levy Corinne 

TITLE=Shift in Clinical Profile of Hospitalized Pneumonia in Children in the Non-pharmaceutical Interventions Period During the COVID-19 Pandemic: A Prospective Multicenter Study

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.782894

DOI=10.3389/fped.2022.782894

ISSN=2296-2360

ABSTRACT=Non-pharmaceutical interventions (NPIs) against coronavirus disease 2019 were implemented in March 2020. These measures were followed by a major impact on viral and non-viral diseases. We aimed to assess the impact of NPI implementation in France on hospitalized community-acquired pneumonia (hCAP) frequency and the clinical and biological characteristics of the remaining cases in children. We performed a quasi-experimental interrupted time series analysis. Between June 2014 and December 2020, 8 pediatric emergency departments throughout France reported prospectively all cases of hCAP in children from age 1 month to 15 years. We estimated the impact on the monthly number of hCAP using segmented linear regression with autoregressive error model. We included 2,972 hCAP cases; 115 occurred during the NPI implementation period. We observed a sharp decrease in the monthly number of hCAP after NPI implementation (-63.0% [95 confidence interval, -86.8% to -39.2%], p < 0.001). Children with hCAP were significantly older during than before the NPI period (median age 3.9 vs 2.3 years, p < 0.0001), and we observed a higher proportion of low inflammatory marker status (43.5% vs 33.1%, p = 0.02). Furthermore, we observed a trend with a decrease in the proportion of cases with pleural effusion (5.3% during the NPI period vs 10.9% before the NPI, p = 0.06). NPI implementation during the COVID-19 pandemic led both to a strong decrease in number of hCAP cases but also a major shift in the clinical profile of children affected, which may reflect a change in pathogens involved.