Objective

The heterogeneous implementation and uptake of nonpharmaceutical interventions (NPIs) during the coronavirus disease 2019 (COVID-19) pandemic amplified the need for locally responsive disease surveillance mechanisms. Using data from a newly developed statewide electronic health record (EHR) consortium in Minnesota, we sought to characterize trends in pediatric viral symptoms, influenza testing, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.

Methods

We conducted a serial cross-sectional analysis of EHR data from 1/1/2017 to 7/30/2021 across 8 large health systems in Minnesota. We included patients ≤18 years of age with any SARS-CoV-2 test, influenza test, or documented diagnostic code which met our viral symptom definition. We plotted week-by-week trends in viral symptoms, SARS-CoV-2 and influenza testing, and test positivity, stratified between children (0–11 years) and adolescents (12–18 years).

Results

We identified 1,079,924 patients ≤18 years of age with viral symptoms or testing; 880,669 (81.5%) were children ≤11 years. Influenza testing and influenza test positivity remained well below historical averages from March 2020 through mid-May 2021. Peaks in viral symptoms during this time were concomitant with peaks in SARS-CoV-2 testing and test positivity, whereas influenza testing and test positivity remained stagnant. Influenza test positivity rates increased substantively among children from May through July 2021.

Conclusions

Viral illness and influenza testing among pediatric patients were below historical averages throughout the COVID-19 pandemic. Ongoing increases in influenza test positivity may merit clinical and public health awareness and intervention. Future NPI policies can be better targeted with insights from collaborative EHR-based surveillance, which enhances real-time, locally sensitive measurement of disease outbreaks.

中文翻译：

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全州电子健康记录联盟 2017 年 1 月至 2021 年 7 月儿科病毒症状、流感检测和 SARS-CoV-2 检测的趋势

客观的

在 2019 年冠状病毒病 (COVID-19) 大流行期间，非药物干预措施 (NPI) 的不同实施和采用加剧了对本地响应疾病监测机制的需求。我们使用来自明尼苏达州新开发的全州电子健康记录 (EHR) 联盟的数据，试图描述儿科病毒症状、流感检测和严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 检测的趋势特征。

方法

我们对明尼苏达州 8 个大型卫生系统从 2017 年 1 月 1 日到 2021 年 7 月 30 日的 EHR 数据进行了系列横断面分析。我们纳入了 18 岁以下的患者，这些患者接受了任何 SARS-CoV-2 检测、流感检测或符合我们病毒症状定义的记录诊断代码。我们绘制了病毒症状、SARS-CoV-2 和流感检测以及检测阳性的每周趋势，在儿童（0-11 岁）和青少年（12-18 岁）之间分层。

结果

我们确定了 1,079,924 名 18 岁以下有病毒症状或检测的患者；880,669 (81.5%) 人是 11 岁以下的儿童。从 2020 年 3 月到 2021 年 5 月中旬，流感检测和流感检测阳性率仍远低于历史平均水平。这段时间病毒症状的峰值与 SARS-CoV-2 检测和检测阳性率的峰值同时出现，而流感检测和检测阳性率仍然停滞不前. 从 2021 年 5 月到 2021 年 7 月，儿童流感检测阳性率大幅上升。

结论

在整个 COVID-19 大流行期间，儿科患者的病毒性疾病和流感检测低于历史平均水平。流感检测阳性的持续增加可能值得临床和公共卫生意识和干预。未来的 NPI 政策可以通过基于 EHR 的协作监测的洞察力更有针对性，从而增强对疾病爆发的实时、本地敏感测量。