目的2019年冠状病毒病(COVID-19)大流行期间急性脑膜炎患病率的变化尚不清楚。这项研究旨在比较日本COVID-19大流行之前和期间急性脑膜炎的患病率。方法回顾性查阅日本全国行政医疗支付系统数据库,诊断程序组合(DPC),从2016年到2022年。在此期间,共有547家医院一致且无缝地提供了DPC数据。研究期间分为以下三个时期:2016年4月至2018年3月(2016-2017财年),2018年4月-2020年3月(2018-2019年),和2020年4月-2022年3月(2020-2021年)。结果在研究期间住院的28,161,806例患者中,28,399例急性脑膜炎住院:16,678例病毒/无菌型,细菌类型为6,189,655真菌类型,429为结核性,2,310癌类型,其他或未知类型的脑膜炎为2,138。在大流行期间,病毒(每个时期n=7,032,n=5,775和n=3,871;p<0.0001)和细菌性脑膜炎(n=2,291,n=2,239和n=1,659;p<0.0001)病例均得到证实。同时,在真菌性脑膜炎(n=212,n=246和n=197;p=0.056)或癌性脑膜炎(n=781,n=795和n=734;p=0.27)中没有观察到下降.结核性脑膜炎病例数的减少是模棱两可的(n=166,n=146和n=117;p=0.014)。大流行期间的下降在年龄<50岁的年轻人群中比在老年人群中更为显著,病毒性和细菌性脑膜炎.结论在COVID-19大流行期间,急性脑膜炎的住院病例明显减少,尤其是年龄<50岁的年轻人群的病毒性和细菌性脑膜炎。
Objective The changes in the prevalence of acute meningitis during the coronavirus disease 2019 (COVID-19) pandemic remain unclear. This study aimed to compare the prevalence of acute meningitis before and during the COVID-19 pandemic in Japan. Methods We retrospectively reviewed the Japanese nationwide administrative medical payment system database, Diagnosis Procedure Combination (DPC), from 2016 to 2022. A total of 547 hospitals consistently and seamlessly offered DPC data during this period. The study period was divided into the following three periods: April 2016 to March 2018 (fiscal years 2016-2017), April 2018-March 2020 (2018-2019), and April 2020-March 2022 (2020-2021). Results Among the 28,161,806 patients hospitalized during the study period, 28,399 were hospitalized for acute meningitis: 16,678 for viral/aseptic type, 6,189 for bacterial type, 655 for fungal type, 429 for tuberculous, 2,310 for carcinomatous type, and 2,138 for other or unknown types of meningitis. A significant decrease during the pandemic was confirmed in viral (n=7,032, n=5,775, and n=3,871 in each period; p<0.0001) and bacterial meningitis (n=2,291, n=2,239, and n=1,659; p<0.0001) cases. Meanwhile, no decrease was observed in fungal meningitis (n=212, n=246, and n=197; p=0.056) or carcinomatous meningitis (n=781, n=795, and n=734; p=0.27). The decrease in the number of tuberculous meningitis cases was equivocal (n=166, n=146, and n=117; p=0.014). The decrease during the pandemic was more remarkable in younger populations aged <50 years than in older populations, both for viral and bacterial meningitis. Conclusion The number of hospitalized cases of acute meningitis clearly decreased during the COVID-19 pandemic, especially for viral and bacterial meningitis in younger populations aged <50 years.