Abstract：
OBJECTIVE: To investigate clinical characteristics and outcomes of patients with pneumococcal meningitis during the COVID-19 pandemic.
METHODS: In a Dutch prospective cohort, risk factors and clinical characteristics of pneumococcal meningitis episodes occurring during the COVID-19 pandemic (starting March 2020) were compared with those from baseline and the time afterwards. Outcomes were compared with an age-adjusted logistic regression model.
RESULTS: We included 1,699 patients in 2006-2020, 50 patients in 2020-2021, and 182 patients in 2021-2023. After March 2020 relatively more alcoholism was reported (2006-2020, 6.1%; 2020-2021, 18%; 2021-2023, 9.7%; P = 0.002) and otitis-sinusitis was less frequently reported (2006-2020, 45%; 2020-2021, 22%; 2021-2023, 47%; P = 0.006). Other parameters, i.e. age, sex, symptom duration or initial C-reactive protein level, remained unaffected. Compared to baseline, lumbar punctures were more frequently delayed (on admission day, 2006-2020, 89%; 2020-2021, 74%; 2021-2022, 86%; P = 0.002) and outcomes were worse (\'good recovery\', 2020-2021, OR 0.5, 95% CI 0.3-0.8).
CONCLUSIONS: During the COVID-19 pandemic, we observed worse outcomes in patients with pneumococcal meningitis. This may be explained by differing adherence to restrictions according to risk groups or by reduced health care quality.
METHODS: In a Dutch prospective cohort, risk factors and clinical characteristics of pneumococcal meningitis episodes occurring during the COVID-19 pandemic (starting March 2020) were compared with those from baseline and the time afterwards. Outcomes were compared with an age-adjusted logistic regression model.
RESULTS: We included 1,699 patients in 2006-2020, 50 patients in 2020-2021, and 182 patients in 2021-2023. After March 2020 relatively more alcoholism was reported (2006-2020, 6.1%; 2020-2021, 18%; 2021-2023, 9.7%; P = 0.002) and otitis-sinusitis was less frequently reported (2006-2020, 45%; 2020-2021, 22%; 2021-2023, 47%; P = 0.006). Other parameters, i.e. age, sex, symptom duration or initial C-reactive protein level, remained unaffected. Compared to baseline, lumbar punctures were more frequently delayed (on admission day, 2006-2020, 89%; 2020-2021, 74%; 2021-2022, 86%; P = 0.002) and outcomes were worse (\'good recovery\', 2020-2021, OR 0.5, 95% CI 0.3-0.8).
CONCLUSIONS: During the COVID-19 pandemic, we observed worse outcomes in patients with pneumococcal meningitis. This may be explained by differing adherence to restrictions according to risk groups or by reduced health care quality.
摘要：
目的：探讨COVID-19大流行期间肺炎球菌性脑膜炎患者的临床特征和转归。
方法：在荷兰的前瞻性队列中，我们将COVID-19大流行期间(2020年3月起)发生肺炎球菌性脑膜炎的危险因素和临床特征与基线和此后时间的危险因素和临床特征进行了比较.结果与年龄调整的逻辑回归模型进行比较。
结果：我们包括2006-2020年的1,699名患者，2020-2021年的50名患者和2021-2023年的182名患者。在2020年3月之后，报告的酒精中毒相对较多（2006-2020年，6.1％；2020-2021年，18％；2021-2023年，9.7％；P=0.002），中耳炎-鼻窦炎的报告频率较低（2006-2020年，45％；2020-2021年，22％；2021-2023年，47％；P=0.006）。其他参数,即年龄，性别,症状持续时间或初始C反应蛋白水平，未受影响。与基线相比，腰椎穿刺更频繁地延迟(在入院当天，2006-2020年，89%；2020-2021年，74%；2021-2022年，86%；P=0.002)，结果更差(“良好复苏”，2020-2021年，OR0.5，95%CI0.3-0.8）。
结论：在COVID-19大流行期间，我们观察到肺炎球菌性脑膜炎患者的预后较差.这可以通过根据风险群体对限制的不同坚持或通过降低医疗保健质量来解释。
方法：在荷兰的前瞻性队列中，我们将COVID-19大流行期间(2020年3月起)发生肺炎球菌性脑膜炎的危险因素和临床特征与基线和此后时间的危险因素和临床特征进行了比较.结果与年龄调整的逻辑回归模型进行比较。
结果：我们包括2006-2020年的1,699名患者，2020-2021年的50名患者和2021-2023年的182名患者。在2020年3月之后，报告的酒精中毒相对较多（2006-2020年，6.1％；2020-2021年，18％；2021-2023年，9.7％；P=0.002），中耳炎-鼻窦炎的报告频率较低（2006-2020年，45％；2020-2021年，22％；2021-2023年，47％；P=0.006）。其他参数,即年龄，性别,症状持续时间或初始C反应蛋白水平，未受影响。与基线相比，腰椎穿刺更频繁地延迟(在入院当天，2006-2020年，89%；2020-2021年，74%；2021-2022年，86%；P=0.002)，结果更差(“良好复苏”，2020-2021年，OR0.5，95%CI0.3-0.8）。
结论：在COVID-19大流行期间，我们观察到肺炎球菌性脑膜炎患者的预后较差.这可以通过根据风险群体对限制的不同坚持或通过降低医疗保健质量来解释。
