Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis
Abstract Background Following non-pharmaceutical interventions (NPI) lifting in 2021, an important surge in childhood lower respiratory tract infections (LRTI) was reported in several countries, raising major concerns about the middle-term consequences of such interventions. Whether this recent upsu...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12916-025-03885-7 |
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| author | Inès Fafi Zein Assad Léa Lenglart Zaba Valtuille Florentia Kaguelidou Camille Aupiais Aurélie Bourmaud Alexis Rybak Stéphane Bechet Corinne Levy Robert Cohen Bruno Frandji Andreas Werner François Angoulvant Romain Basmaci Naïm Ouldali |
| author_facet | Inès Fafi Zein Assad Léa Lenglart Zaba Valtuille Florentia Kaguelidou Camille Aupiais Aurélie Bourmaud Alexis Rybak Stéphane Bechet Corinne Levy Robert Cohen Bruno Frandji Andreas Werner François Angoulvant Romain Basmaci Naïm Ouldali |
| author_sort | Inès Fafi |
| collection | DOAJ |
| description | Abstract Background Following non-pharmaceutical interventions (NPI) lifting in 2021, an important surge in childhood lower respiratory tract infections (LRTI) was reported in several countries, raising major concerns about the middle-term consequences of such interventions. Whether this recent upsurge overwhelms the initial benefit of NPI remains unknown. Methods We conducted an interrupted time-series analysis based on exhaustive national surveillance systems. All hospitalisations from January 2015 to March 2023 and all ambulatory visits for LRTI from a network of 110 paediatricians from June 2017 to March 2023 were included. The main outcome was the monthly incidence of children hospitalised for LRTI per 100,000 over time, assessed by a seasonally adjusted quasi-Poisson regression model. Results We included 845,047 hospitalisations. The incidence of hospitalisation for LRTI significantly decreased during the NPI period (− 61.7%, 95% CI − 98.4 to − 24.9) and rebounded following NPI lifting, exceeding the pre-NPI baseline trend (+ 12.8%, 95% CI 6.7 to 19.0). We observed similar trends for hospitalisation due to bronchiolitis, pneumonia and pneumonia with pleural effusion, along with ambulatory LRTI. Overall, despite the recent rebound, 31,777 (95% CI, 25,375 to 38,179) hospitalisations for paediatric LRTI were averted since NPI implementation up to 2023. Conclusions Three years after their implementation, despite an increase in LRTI incidence, the middle-term impact of NPI remains highly beneficial in preventing overall paediatric LRTI. The implementation of some societally acceptable NPI, particularly during epidemics, may be considered in the future to further reduce the burden of paediatric LRTI. |
| format | Article |
| id | doaj-art-9988dea58ba846fb873c7146890fc525 |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medicine |
| spelling | doaj-art-9988dea58ba846fb873c7146890fc5252025-02-09T12:40:56ZengBMCBMC Medicine1741-70152025-02-0123111010.1186/s12916-025-03885-7Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysisInès Fafi0Zein Assad1Léa Lenglart2Zaba Valtuille3Florentia Kaguelidou4Camille Aupiais5Aurélie Bourmaud6Alexis Rybak7Stéphane Bechet8Corinne Levy9Robert Cohen10Bruno Frandji11Andreas Werner12François Angoulvant13Romain Basmaci14Naïm Ouldali15Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de ParisDepartment of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de ParisParis Cité University, Antimicrobials, Modelling, Evolution (IAME)EA7323 Perinatal and Paediatric Pharmacology and Therapeutic Assessment, Paris Cité UniversityEA7323 Perinatal and Paediatric Pharmacology and Therapeutic Assessment, Paris Cité UniversityParis Cité University, Antimicrobials, Modelling, Evolution (IAME)Clinical Investigation Centre, INSERM CIC1426, Robert Debré University Hospital, Assistance Publique-Hôpitaux de ParisFrench Paediatric Infectious Disease GroupAssociation Clinique Et Thérapeutique Infantile du Val-de-Marne France (ACTIV)French Paediatric Infectious Disease GroupFrench Paediatric Infectious Disease GroupClinical Research Centre, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, IMRB-GRC GEMINIAssociation Clinique Et Thérapeutique Infantile du Val-de-Marne France (ACTIV)Department of General Paediatrics, Department Women-Mother-Child, Lausanne University HospitalParis Cité University, Antimicrobials, Modelling, Evolution (IAME)Department of General Paediatrics, Paediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de ParisAbstract Background Following non-pharmaceutical interventions (NPI) lifting in 2021, an important surge in childhood lower respiratory tract infections (LRTI) was reported in several countries, raising major concerns about the middle-term consequences of such interventions. Whether this recent upsurge overwhelms the initial benefit of NPI remains unknown. Methods We conducted an interrupted time-series analysis based on exhaustive national surveillance systems. All hospitalisations from January 2015 to March 2023 and all ambulatory visits for LRTI from a network of 110 paediatricians from June 2017 to March 2023 were included. The main outcome was the monthly incidence of children hospitalised for LRTI per 100,000 over time, assessed by a seasonally adjusted quasi-Poisson regression model. Results We included 845,047 hospitalisations. The incidence of hospitalisation for LRTI significantly decreased during the NPI period (− 61.7%, 95% CI − 98.4 to − 24.9) and rebounded following NPI lifting, exceeding the pre-NPI baseline trend (+ 12.8%, 95% CI 6.7 to 19.0). We observed similar trends for hospitalisation due to bronchiolitis, pneumonia and pneumonia with pleural effusion, along with ambulatory LRTI. Overall, despite the recent rebound, 31,777 (95% CI, 25,375 to 38,179) hospitalisations for paediatric LRTI were averted since NPI implementation up to 2023. Conclusions Three years after their implementation, despite an increase in LRTI incidence, the middle-term impact of NPI remains highly beneficial in preventing overall paediatric LRTI. The implementation of some societally acceptable NPI, particularly during epidemics, may be considered in the future to further reduce the burden of paediatric LRTI.https://doi.org/10.1186/s12916-025-03885-7COVID-19 pandemicLower respiratory tract infectionsRespiratory pathogensTime-series analysis |
| spellingShingle | Inès Fafi Zein Assad Léa Lenglart Zaba Valtuille Florentia Kaguelidou Camille Aupiais Aurélie Bourmaud Alexis Rybak Stéphane Bechet Corinne Levy Robert Cohen Bruno Frandji Andreas Werner François Angoulvant Romain Basmaci Naïm Ouldali Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis BMC Medicine COVID-19 pandemic Lower respiratory tract infections Respiratory pathogens Time-series analysis |
| title | Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis |
| title_full | Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis |
| title_fullStr | Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis |
| title_full_unstemmed | Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis |
| title_short | Did the resurgence of childhood lower respiratory infections offset the initial benefit of COVID-19-related non-pharmaceutical interventions in children? A time-series analysis |
| title_sort | did the resurgence of childhood lower respiratory infections offset the initial benefit of covid 19 related non pharmaceutical interventions in children a time series analysis |
| topic | COVID-19 pandemic Lower respiratory tract infections Respiratory pathogens Time-series analysis |
| url | https://doi.org/10.1186/s12916-025-03885-7 |
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