Effect of the COVID-19 Pandemic on Lower Respiratory Tract Infection Determinants in Thai Hospitalized Children: National Data Analysis 2015-2020

Rattapon Uppala; Phanthila Sitthikarnkha; Sirapoom Niamsanit; Sumitr Sutra; Kaewjai Thepsuthammarat; Leelawadee Techasatian; Nattachai Anantasit; Jamaree Teeratakulpisarn

doi:10.3390/tropicalmed7080151

Effect of the COVID-19 Pandemic on Lower Respiratory Tract Infection Determinants in Thai Hospitalized Children: National Data Analysis 2015-2020

Trop Med Infect Dis. 2022 Jul 28;7(8):151. doi: 10.3390/tropicalmed7080151.

Authors

Rattapon Uppala¹, Phanthila Sitthikarnkha¹, Sirapoom Niamsanit¹, Sumitr Sutra¹, Kaewjai Thepsuthammarat², Leelawadee Techasatian¹, Nattachai Anantasit³, Jamaree Teeratakulpisarn¹

Affiliations

¹ Department of Pediatrics, Faculty of Medicine, Khon Kaen University, 123 Mittraphap Road, Muang, Khon Kaen 40002, Thailand.
² Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
³ Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

Abstract

Background: The COVID-19 outbreak emerged in January 2020 and remains present in 2022. During this period, nonpharmaceutical interventions (NPIs) have been used to reduce the spread of COVID-19 infection. Nationwide data analysis should be pushed as the new standard to demonstrate the impact of COVID-19 infection on other respiratory illnesses and the reliability of NPIs during treatment. Objective: This study aims to identify and compare the incidence of lower respiratory tract infections (LRTIs) among children in Thailand before and after the emergence of COVID-19. Methods: A retrospective study was carried out in hospitalized children under the age of 18 in Thailand from October 2015 to September 2020. The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Thai Modification, was used to identify patient diagnoses (ICD-10-TM). The data were extracted from the Universal Coverage Health Security Scheme Database. Results: A total of 1,610,160 admissions were attributed to LRTIs. The most common diagnosis was pneumonia (61.9%). Compared to the 2019 fiscal year, the number of hospitalizations due to LRTIs decreased by 33.9% in the 2020 fiscal year (COVID-19 period) (282,590 vs. 186,651). The incidence of all three diagnostic groupings was substantially lower in the pre- and post-COVID-19 eras, with a decrease of 28% in the pneumonia group (incidence rate ratio (IRR) = 0.72; 95% confidence interval (CI): 0.71 to 0.72), 44% in the bronchiolitis group (IRR = 0.56; 95% CI: 0.55 to 0.57), and 34% in the bronchitis group (IRR = 0.66; 95% CI: 0.65 to 0.67). Between fiscal years 2019 and 2020, the overall monthly cost of all hospitalizations for LRTIs decreased considerably (p value < 0.001). Conclusions: NPIs may decrease the number of pediatric hospitalizations related to LRTIs. All policies designed to prevent the spread of COVID-19 must be continually utilized to maintain the prevention of LRTIs.

Keywords: COVID-19; children; hospitalization; lower respiratory tract infection; nonpharmaceutical interventions.

Grants and funding

This research received no external funding.