新型冠状病毒肺炎疫情前后2年儿童重症监护病房疾病谱的变化

Changes in the disease spectrum in the pediatric intensive care units within 2 years before and after the outbreak of coronavirus disease 2019

摘要:

目的 对比新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）疫情暴发前后2年内儿童重症监护病房（pediatric intensive care units，PICU）住院患儿疾病谱的变化。 方法 收集济宁医学院附属医院PICU 2018年1月至2019年12月（COVID-19疫情前组）和2020年1月至2021年12月（COVID-19疫情后组）所有住院患儿的疾病诊断相关信息，对2组患儿的疾病谱进行统计学分析。 结果 COVID-19疫情前组纳入2 368例患儿，COVID-19疫情后组纳入1 653例患儿。COVID-19疫情后组住院人数较COVID-19疫情前组减少了30.19%。COVID-19疫情前后2组年龄构成差异有统计学意义（P<0.05）。COVID-19疫情前组病例数居前10位的疾病依次为：呼吸系统疾病、神经系统疾病、脓毒症、危重症、循环系统疾病、神经外科重症、消化系统疾病、意外伤害、内分泌系统疾病、肿瘤。COVID-19疫情后组病例数居前10位的疾病依次为：呼吸系统疾病、神经系统疾病、脓毒症、循环系统疾病、意外伤害、内分泌系统疾病、神经外科重症、急腹症、创伤外科疾病、消化系统疾病。COVID-19疫情后组呼吸系统疾病、危重症、神经外科重症占比低于COVID-19疫情前组（P<0.05），而意外伤害、急腹症、内分泌系统疾病、创伤外科疾病、脓毒症占比高于COVID-19疫情前组（P<0.05）。 结论 COVID-19疫情后PICU住院患儿数量明显减少，疫情前后2年疾病谱发生了显著的变化。COVID-19疫情期间采取的相关防控措施可减少儿童呼吸系统疾病、神经系统疾病及其他危重症等的发生，但需加强疫情期间意外伤害的预防和慢性病管理。

Abstract:

Objective To investigate the changes in the disease spectrum among hospitalized children in the pediatric intensive care units (PICU) within 2 years before and after the outbreak of coronavirus disease 2019 (COVID-19). Methods The related data on disease diagnosis were collected from all children who were hospitalized in the PICU of Affiliated Hospital of Jining Medical College from January 2018 to December 2019 (pre-COVID-19 group) and from January 2020 to December 2021 (post-COVID-19 group). A statistical analysis was performed for the disease spectrum of the two groups. Results There were 2 368 children in the pre-COVID-19 group and 1 653 children in the post-COVID-19 group. The number of children in the post-COVID-19 group was reduced by 30.19% compared with that in the pre-COVID-19 group. There was a significant difference in age composition between the two groups (P<0.05). The top 10 diseases in the pre-COVID-19 group by number of cases were respiratory diseases, neurological diseases, sepsis, critical illness, circulatory system diseases, severe neurosurgical diseases, digestive system diseases, unintentional injuries, endocrine system diseases, and tumors. The top 10 diseases in the post-COVID-19 group by number of cases were respiratory diseases, neurological diseases, sepsis, circulatory system diseases, unintentional injuries, endocrine system diseases, severe neurosurgical diseases, acute abdomen, trauma surgical diseases, and digestive system diseases. The proportions of respiratory diseases, critical illness and severe neurosurgical diseases in the post-COVID-19 group were lower than those in the pre-COVID-19 group (P<0.05), while the proportions of unintentional injuries, acute abdomen, endocrine system diseases, trauma surgical diseases and sepsis were higher than those in the pre-COVID-19 group (P<0.05). Conclusions COVID-19 epidemic has led to a significant reduction in the number of children admitted to the PICU, and there are significant changes in the disease spectrum within 2 years before and after the outbreak of COVID-19. Relevant prevention and control measures taken during the COVID-19 epidemic can reduce the incidence of respiratory diseases, neurological diseases, and other critical illness in children, but it is necessary to strengthen the prevention of unintentional injuries and chronic disease management during the epidemic.