PDF(Pubmed)
Abstract：
BACKGROUND: Acute asthma exacerbation in children is often caused by respiratory infections. In this study, a coordinated national surveillance system for acute asthma hospitalizations and causative respiratory infections was established. We herein report recent trends in pediatric acute asthma hospitalizations since the COVID-19 pandemic in Japan.
METHODS: Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated.
RESULTS: From fiscal years 2010-2019, the median number of acute asthma hospitalizations per year was 3524 (2462-4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020-2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma.
CONCLUSIONS: SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
METHODS: Thirty-three sentinel hospitals in Japan registered all of their hospitalized pediatric asthma patients and their causal pathogens. The changes in acute asthma hospitalization in children before and after the onset of the COVID-19 pandemic and whether or not COVID-19 caused acute asthma exacerbation were investigated.
RESULTS: From fiscal years 2010-2019, the median number of acute asthma hospitalizations per year was 3524 (2462-4570), but in fiscal years 2020, 2021, and 2022, the numbers were 820, 1,001, and 1,026, respectively (the fiscal year in Japan is April to March). This decrease was observed in all age groups with the exception of the 3- to 6-year group. SARS-CoV-2 was evaluated in 2094 patients from fiscal years 2020-2022, but the first positive case was not detected until February 2022. Since then, only 36 of them have been identified with SARS-CoV-2, none of which required mechanical ventilation. Influenza, RS virus, and human metapneumovirus infections also decreased in FY 2020. In contrast, 24% of patients had not been receiving long-term control medications before admission despite the severity of bronchial asthma.
CONCLUSIONS: SARS-CoV-2 was hardly detected in children with acute asthma hospitalization during the COVID-19 pandemic. This result indicated that SARS-CoV-2 did not induce acute asthma exacerbation in children. Rather, infection control measures implemented against the pandemic may have consequently reduced other respiratory virus infections and thus acute asthma hospitalizations during this period. However, the fact that many hospitalized patients have not been receiving appropriate long-term control medications is a major problem that should be addressed.
摘要：
背景：儿童哮喘急性加重通常是由呼吸道感染引起的。在这项研究中,建立了急性哮喘住院和呼吸道感染的国家协调监测系统.我们在此报告了日本自COVID-19大流行以来儿科急性哮喘住院的最新趋势。
方法：日本33家前哨医院登记了所有住院的小儿哮喘患者及其病原体。研究了COVID-19大流行发生前后儿童急性哮喘住院的变化，以及COVID-19是否导致急性哮喘加重。
结果：从2010-2019财年，每年急性哮喘住院的中位数为3524（2462-4570），但在2020、2021和2022财政年度，这些数字分别为820、1,001和1,026（日本的财政年度为4月至3月）。除3至6岁组外，所有年龄组均观察到这种下降。在2020-2022财政年度的2094名患者中评估了SARS-CoV-2，但直到2022年2月才发现第一例阳性病例。从那以后,其中只有36例被确认为SARS-CoV-2，没有一种需要机械通气。流感,RS病毒,人类偏肺病毒感染在2020财年也有所下降。相比之下,尽管支气管哮喘严重，但仍有24％的患者在入院前未接受长期对照药物治疗。
结论：在COVID-19大流行期间住院的急性哮喘患儿中几乎没有发现SARS-CoV-2。这一结果表明SARS-CoV-2不会引起儿童哮喘急性加重。相反，针对大流行实施的感染控制措施可能因此减少了其他呼吸道病毒感染，从而在此期间减少了急性哮喘住院。然而,许多住院患者没有接受适当的长期控制药物，这是一个应该解决的主要问题。
方法：日本33家前哨医院登记了所有住院的小儿哮喘患者及其病原体。研究了COVID-19大流行发生前后儿童急性哮喘住院的变化，以及COVID-19是否导致急性哮喘加重。
结果：从2010-2019财年，每年急性哮喘住院的中位数为3524（2462-4570），但在2020、2021和2022财政年度，这些数字分别为820、1,001和1,026（日本的财政年度为4月至3月）。除3至6岁组外，所有年龄组均观察到这种下降。在2020-2022财政年度的2094名患者中评估了SARS-CoV-2，但直到2022年2月才发现第一例阳性病例。从那以后,其中只有36例被确认为SARS-CoV-2，没有一种需要机械通气。流感,RS病毒,人类偏肺病毒感染在2020财年也有所下降。相比之下,尽管支气管哮喘严重，但仍有24％的患者在入院前未接受长期对照药物治疗。
结论：在COVID-19大流行期间住院的急性哮喘患儿中几乎没有发现SARS-CoV-2。这一结果表明SARS-CoV-2不会引起儿童哮喘急性加重。相反，针对大流行实施的感染控制措施可能因此减少了其他呼吸道病毒感染，从而在此期间减少了急性哮喘住院。然而,许多住院患者没有接受适当的长期控制药物，这是一个应该解决的主要问题。
