Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic

Sheila F Lumley; Nicholas Richens; Emily Lees; Jack Cregan; Elizabeth Kalimeris; Sarah Oakley; Marcus Morgan; Shelley Segal; Moya Dawson; A Sarah Walker; David W Eyre; Derrick W Crook; Sally Beer; Alex Novak; Nicole E Stoesser; Philippa C Matthews

doi:10.1016/j.jinf.2021.10.022

Changes in paediatric respiratory infections at a UK teaching hospital 2016-2021; impact of the SARS-CoV-2 pandemic

J Infect. 2022 Jan;84(1):40-47. doi: 10.1016/j.jinf.2021.10.022. Epub 2021 Oct 29.

Authors

Affiliations

¹ NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK. Electronic address: sheila.lumley@trinity.ox.ac.uk.
² NHS Foundation Trust, Oxford University Hospitals, Oxford, UK.
³ Department of Paediatrics, University of Oxford, Oxford UK.
⁴ Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK.
⁵ Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.
⁶ NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK; Nuffield Department of Population Health, University of Oxford, Oxford, UK; Big Data Institute, University of Oxford, Oxford, UK.
⁷ NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK.
⁸ NHS Foundation Trust, Oxford University Hospitals, Oxford, UK; Nuffield Department of Medicine, University of Oxford, Medawar Building, South Parks Road, Oxford OX1 3SY, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, UK. Electronic address: philippa.mathews@ndm.ox.ac.uk.

Abstract

Objective To describe the impact of the SARS-CoV-2 pandemic on the incidence of paediatric viral respiratory tract infection in Oxfordshire, UK. Methods Data on paediatric Emergency Department (ED) attendances (0-15 years inclusive), respiratory virus testing, vital signs and mortality at Oxford University Hospitals were summarised using descriptive statistics. Results Between 1-March-2016 and 30-July-2021, 155,056 ED attendances occurred and 7,195 respiratory virus PCRs were performed. Detection of all pathogens was suppressed during the first national lockdown. Rhinovirus and adenovirus rates increased when schools reopened September-December 2020, then fell, before rising in March-May 2021. The usual winter RSV peak did not occur in 2020/21, with an inter-seasonal rise (32/1,000 attendances in 0-3 yr olds) in July 2021. Influenza remained suppressed throughout. A higher paediatric early warning score (PEWS) was seen for attendees with adenovirus during the pandemic compared to pre-pandemic (p = 0.04, Mann-Witney U test), no other differences in PEWS were seen. Conclusions SARS-CoV-2 caused major changes in the incidence of paediatric respiratory viral infection in Oxfordshire, with implications for clinical service demand, testing strategies, timing of palivizumab RSV prophylaxis, and highlighting the need to understand which public health interventions are most effective for preventing respiratory virus infections.

Keywords: Influenza; Paediatric; Respiratory syncytial virus; Respiratory tract infection; Respiratory virus; Rhinovirus; SARS-CoV-2.

MeSH terms

COVID-19*
Child
Communicable Disease Control
Hospitals, Teaching
Humans
Pandemics
Respiratory Syncytial Virus Infections* / epidemiology
Respiratory Tract Infections* / epidemiology
SARS-CoV-2
United Kingdom