Pre-pandemic and pandemic patterns of respiratory diseases referred to pediatric emergency: experience from Lithuanian university of health sciences hospital

Abstract

Background and aim Due to different protection methods (face masks, social distancing etc.) following SARS-CoV-1 pandemics, many countries reported decrease in respiratory tract infections (RTI). Thus, we aimed to investigate pre-pandemic and pandemic pediatric RTI cases referred to our University Hospital pediatric emergency (PED). Methods Retrospective analysis from electronical record data system was conducted including children aged 0-18 years from 2018 1st of January to 2021 31st of December. We collected following working diagnosis: upper viral, bacterial respiratory tract diseases (URTI) (tonsillitis, adenoiditis, nasopharyngitis, pharyngitis, laryngitis); lower respiratory diseases (LRTI) (tracheitis, bronchitis, tracheobronchitis, bronchiolitis, asthma, pneumonia), and influenza. Data were analyzed according to year and/or age group. Statistical analysis was done using SPSS 27.0; p< 0.05 was considered significant. Results In total, 17620 cases of RTI were included, 45% were female. Clear decrease in URTI and LRTI was observed starting from 2020 March (first lock-down in Lithuania) (URTI:3740/2018y4201/2019y2091/2020y3522/2021y; LRTI:969/2018y1054/2019y 533/2020y944/2021y). Biggest drop was seen in flu cases, with clear decrease since 2020 March (1222121310). In total, 1-12y children comprised majority of URTI (92%) and LRTI (86%). We observed an increase of URTI in 2021 in 1-5y age group (68%(from total)/201 8y69%/2019y75%/2020y81%/2021y). Same patterns were observed in LRTI. We noted significant increase in 2021 in bronchiolitis (52/2018y47/201 9y26/2020y80/2021y), laryngitis (253/2018y315/2019y83/2020y6 66/2021y) and bronchitis (306/2018y295/2019y155/2020y423/2021y). Conclusions Our analysis revealed clear patterns of drop of RTI during pandemics and significant increase in 2021y of such viral diseases as bronchiolitis and laryngitis, and bronchitis. This contributes to other worldwide data and shows a clear post-pandemic shift of some of the viral diseases.