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Townley B, Akin D, Dimaguila GL, Sawires R, Sepulveda Kattan G, King S, Bines J, Wood N, Lambert S, Buttery J. Exploring the Infectious Contribution to Intussusception Causality Using the Effects of COVID-19 Lockdowns in Australia: An Ecological Study. Clin Infect Dis 2024; 79:255-262. [PMID: 38376945 DOI: 10.1093/cid/ciae084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases <2 years of age are classed as idiopathic, with viral infection implicated as one of the causes. Coronavirus disease 2019 (COVID-19) public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were greater than would be expected with our previous understanding of its infectious etiology. METHODS We conducted a retrospective, multistate, ecological study over a 12-year period. Monthly case numbers of "intussusception"-coded admissions (code K56.1; International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) were acquired from state-wide admissions data sets from New South Wales, Victoria, and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared with non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods. RESULTS We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the <2-year age groups, with Victoria experiencing a 62.7% reduction (rate ratio, 0.37; P < .001) and New South Wales a 40.1% reduction (0.599; P = .006) during lockdown times. Controls for variations in lockdown restrictions between both regional and metropolitan areas also showed expected decreases. CONCLUSIONS Our ecological study demonstrates significant decreases in the frequency of pediatric intussusception admissions during the COVID-19 lockdown periods. The unexpected magnitude of the reductions suggests that the true proportion of infectious disease-caused idiopathic intussusception is greatly underestimated.
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Affiliation(s)
- Benjamin Townley
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Medicine, Monash University, Clayton, Victoria, Australia
| | - Deniz Akin
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Gerardo Luis Dimaguila
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Rana Sawires
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Medicine, Monash University, Clayton, Victoria, Australia
| | - Gonzalo Sepulveda Kattan
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Sebastian King
- Department of Paediatrics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Pediatric Surgery, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Julie Bines
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Gastroenterology and Clinical Nutrition, Royal Children's Hospital, Parkville, Victoria, Australia
- Enteric Diseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Nicholas Wood
- National Centre for Immunisation Research and Surveillance, Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Stephen Lambert
- National Centre for Immunisation Research and Surveillance, Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- Communicable Diseases Branch, Queensland Health, Brisbane, Queensland, Australia
| | - Jim Buttery
- Child Health Analytics and Informatics Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Infectious Diseases Unit, Royal Children's Hospital, Parkville, Victoria, Australia
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Impact of coronavirus disease 2019 on pediatric intestinal intussusception in the United States. Pediatr Radiol 2023; 53:827-831. [PMID: 36593279 PMCID: PMC9807418 DOI: 10.1007/s00247-022-05572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 11/06/2022] [Accepted: 12/14/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Masking and social distancing to mitigate the spread of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus curbed the spread of other viruses. Given a potential link between viral illnesses and ileocolic intussusception, the purpose of this study is to characterize trends in incidence, diagnosis and management of pediatric intussusception in the United States in the context of the coronavirus disease 2019 (COVID-19) pandemic. MATERIALS AND METHODS This cross-sectional retrospective study used the Pediatric Hospital Information System and included children (ages 0-17 years) with a primary diagnosis of intussusception (ICD-10 [International Classification of Diseases, Tenth Revision]: K56.1) from January 2018 to December 2021. Descriptive statistics and chi-square analyses were used to characterize and compare proportions pre-COVID (2018 and 2019) to 2020 and 2021. RESULTS Eight thousand one hundred forty-three encounters met inclusion criteria. Intussusception diagnoses declined in 2020 (n = 1,480) compared to 2019 (n = 2,321) and 2018 (n = 2,171) but returned to pre-COVID levels in 2021 (n = 2,171). Patient age was similar across years (mean age in years: 2018: 2.3; 2019: 2.1; 2020: 2.3; 2021: 2.3). There was no significant change in the proportion of patients who underwent imaging in 2020 (96% [1,415/1,480]) compared to the other years in the study (2018: 96% [2,093/2,171], P = 0.21; 2019: 97% [2,253/2,321], P = 0.80; 2021: 96% [1,415/1,480], P = 0.85). There was a statistically significant but minimal increase in the proportion of cases treated with surgery in 2020 compared to 2019 (2020: 17.8% vs. 2019: 15%, P = 0.02); however, this was not replicated in the pairwise comparison of 2020 to 2018 (2020: 17.8% vs. 2018: 16.4%, P = 0.23). There was a statistically significant increase in the proportion of cases treated with surgery in 2020 compared to 2021 (2020: 17.8% vs. 2021: 14%, P = 0.001). CONCLUSION Pediatric intussusception diagnoses decreased at a national level in 2020 compared to previous years, with a rebound increase in 2021. This may reflect a secondary benefit of public health interventions imposed to curb the spread of COVID-19.
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Cho S, Ju HR, Oh H, Choi ES, Lee JA. The association between the restriction of daily life and depression during the COVID-19 pandemic in Korea: a nationwide based survey. Sci Rep 2022; 12:17722. [PMID: 36271227 PMCID: PMC9586933 DOI: 10.1038/s41598-022-21301-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/26/2022] [Indexed: 01/18/2023] Open
Abstract
The coronavirus (COVID-19) pandemic has led to substantial daily life changes for people worldwide. We investigated the association between daily life restrictions and depression during the COVID-19 pandemic based on the Korea Community Health Survey. Daily life restrictions were evaluated using a questionnaire to population into three restriction categories: no/slightly, moderately, and severely. Depression was assessed by the Korean version of the Patient Health Questionnaire-9 (PHQ-9). Chi-square tests and Fisher's exact tests were used to compare the demographic characteristics of individuals with and without depression. Logistic regression was used to assess the association between the severity of daily life restrictions and the prevalence of depression. The prevalence of depression was 2.4% in the total population: 5.7% in the severely restricted group and 2.7% in the moderately restricted group. After adjusting for age, sex, educational level, income, marital status, and employment status, the severely restricted group was more likely to have depression than was the no change/slightly restricted group (OR = 2.40, 95% CI 2.16-2.67, p < 0.001). Employers with severely restricted daily life exhibited a higher OR for depression compared to the no/slightly restricted group (OR = 3.24, 95% CI 2.37-4.45, p < 0.001). It is necessary to consider the mental health of vulnerable affected by the COVID-19 pandemic.
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Affiliation(s)
- Sunwoo Cho
- Workplace Health Institute, Total Health Care Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, B1, 55 Sejong-daero, Jung-gu, Seoul, South Korea
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hyo Rim Ju
- Department of Family Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, South Korea
| | - Hyoungseok Oh
- Workplace Health Institute, Total Health Care Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, B1, 55 Sejong-daero, Jung-gu, Seoul, South Korea
| | - Eun-Suk Choi
- Workplace Health Institute, Total Health Care Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, B1, 55 Sejong-daero, Jung-gu, Seoul, South Korea
| | - Jung Ah Lee
- Workplace Health Institute, Total Health Care Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, B1, 55 Sejong-daero, Jung-gu, Seoul, South Korea.
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Kim DH, Cho JH, Park SJ, Seo SH, Ahn HH. Impact of COVID-19 on Clinicopathological Spectrum of Pityriasis Rosea in Korea. J Korean Med Sci 2022; 37:e190. [PMID: 35726143 PMCID: PMC9247725 DOI: 10.3346/jkms.2022.37.e190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Pityriasis rosea (PR) is a papulosquamous eruption with generally unknown origin but suspected to be related to viral etiologies. The clinicopathological spectrum of several disorders with viral etiologies has been altered after the coronavirus disease 2019 (COVID-19) pandemic. The author group could experience coherent histological alterations in PR after the COVID-19 pandemic. This study aimed to investigate how the clinicopathological findings of PR were changed after the COVID-19 pandemic. METHODS Patients (n = 11) diagnosed with PR based on the clinical manifestations and skin biopsies between February 2018 and October 2019 and 11 patients in February 2020 and October 2021 were retrospectively analyzed by investigating the medical records. RESULTS The patients with PR during the COVID-19 pandemic demonstrated statistically significant histopathological alterations from classic brisk and dense infiltration pattern to dormant and sparse infiltration and psoriasiform-dominant patterns (P = 0.019). PR was associated with more frequent pruritus during the pandemic period (P = 0.027). CONCLUSION In conclusion, PR demonstrated a significant histopathological alteration with more frequent pruritus during the COVID-19 pandemic. The comparative results about clinicopathological findings of PR will provide a useful reference for dermatologists in the diagnostic process of PR in the COVID-19 pandemic.
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Affiliation(s)
- Dai Hyun Kim
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
- Department of Anatomy, Korea University College of Medicine, Seoul, Korea
| | - Jun Hyuk Cho
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Sung Jin Park
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Soo Hong Seo
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea.
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