Epidemiology of respiratory infections in Finnish children during the early phases of the COVID-19 pandemic
Year: 2023
Type: dissertation
Study design: Observational Study
Abstract: The coronavirus disease 2019 (COVID-19) pandemic changed people's lives in a way unseen since the Spanish flu pandemic of 1918-1920 and polio in the first half of the 20 th century.Non-pharmaceutical interventions in the spring of 2020 especially forced people to change their normal approaches to social interaction because of gathering restrictions, school and day care closures and the recommendation to work remotely.The preventive measures that aimed to reduce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates offered a unique opportunity to study how changing circumstances in 2020 influenced the epidemiology of respiratory infections in children and infection-related matters during this extraordinary time.This dissertation comprises five register-based studies.The data were collected from the National Infectious Disease Register, the Care Register for Health Care, the register of reimbursed prescription medicines and patient discharge records from Mikkeli Central Hospital (MCH), Tampere University Hospital (TAUH) and Central Finland Hospital (CFH).Our results demonstrate that non-pharmaceutical interventions in the spring of 2020 were effective in reducing emergency department visits by 8 day-care-aged children, and the reduction seems not to have been due to impaired access to treatment.We also found that it significantly decreased respiratory infection incidences in children.Two weeks after the strictest non-pharmaceutical interventions were introduced, the incidence of viral respiratory infection detections in the pediatric population was 99% lower than it had been in previous years.This effect lasted through the summer of 2020.The rhinovirus incidence started to increase that summer, reaching 2.1 per 100,000 children in week 31 of 2020 (95% confidence interval [CI], 1.6-3.8).Later, the increase accelerated, together with the increased SARS-CoV-2 incidence.The number of tonsillar surgeries and tympanostomies due to infections among children decreased in 2020.In April, compared to previous years, the incidence of tonsil surgery decreased by 96%, and the number of tympanostomies decreased by 81%.Due to cancelled elective operations and the transfer of hospital personnel, the waiting times for these procedures were longer in 2020 compared to previous years.During the first and second waves of COVID-19, from March 2020 to December 2020, the number of dispensed antibiotic courses and asthma medicines for children declined by 55.8% and 19.8%, respectively.These reductions led to reimbursement savings of 3.4 million euros.Based on our findings, this decrease was not due to insufficient primary care resources; since August 2020, the visit rate increased, and the number of dispensed drugs was still lower than in the previous year.In conclusion, the social restrictions due to COVID-19 led to major changes in the respiratory pathogen epidemiology of Finnish children.This reduction in virus circulation resulted in a considerable decrease in emergency department visits, dispensed antibiotic courses and common otolaryngological operations.When considering the introduction of nonpharmaceutical interventions, evaluating their potential short-term and long-term effects is important.
Author: Haapanen, Marjut
Institution: University of Eastern Finland
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7215434601