Abstract

During COVID-19, public health measures including masks and social distancing decreased viral upper respiratory infections (URI). Upper respiratory infections are the most common infectious etiology for low-risk pediatric febrile neutropenia (FN). This single-center, quasi-experimental, pre-post study was designed to understand the impact of public health measures on FN admissions and outcomes in the general pediatric oncology population during the COVID (March 2020–February 2021) vs. pre-COVID era (January 2018–February 2020) and their respective respiratory seasons (November–February). Episodes were risk-stratified using a tool recommended by the Children’s Oncology Group. Descriptive and bivariate statistics were used to compare admission characteristics and outcomes. Comparing respiratory seasons, the Covid-era season had 60% fewer URI diagnoses (5/12), while high-risk episodes (63.6% [28/44] vs. 44.2% [23/52]) and intensive care admissions (18.2% [8/44] vs. 3.8% [2/52]) increased. Between eras, URIs were lower in the COVID-era (10.8% [16/148] vs. 19.9% [67/336]; p = 0.01), but admission characteristics and severe outcomes were not different. The impact of public health measures was most prominent during the respiratory season. Despite decreased incidence of URIs, the overall admission characteristics and severe outcomes were minimally impacted due to the brevity of respiratory seasons, but larger studies are warranted.

摘要

在 COVID-19 期间，包括口罩和社交距离在内的公共卫生措施减少了病毒性上呼吸道感染 (URI)。上呼吸道感染是低危儿科发热性中性粒细胞减少症 (FN) 最常见的感染性病因。这项单中心、准实验性、事后研究旨在了解 COVID（2020 年 3 月至 2021 年 2 月）与 COVID 前时代相比，公共卫生措施对普通儿科肿瘤人群 FN 入院和结果的影响（2018 年 1 月至 2020 年 2 月）及其各自的呼吸季节（11 月至 2 月）。使用儿童肿瘤学小组推荐的工具对发作进行风险分层。使用描述性和双变量统计来比较入院特征和结果。比较呼吸季节，Covid 时代的 URI 诊断减少了 60% (5/12)，而高风险事件 (63.6% [28/44] 对 44.2% [23/52]) 和重症监护入院 (18.2% [8/ 44] 对比 3.8% [2/52]) 增加。在两个时代之间，URI 在 COVID 时代较低（10.8% [16/148] 对 19.9% [67/336]；p  = 0.01)，但入院特征和严重后果没有差异。公共卫生措施的影响在呼吸季节最为突出。尽管 URI 的发生率有所下降，但由于呼吸季节短暂，总体入院特征和严重结果受到的影响微乎其微，但仍需要进行更大规模的研究。