| Abstract | Cilj istraživanja: Cilj ovog istraživanja bio je prikazati karakteristike dojenčadi
oboljele od akutne infekcije dišnog sustava (ALRI) u razdoblju prije i tijekom COVID
pandemije.
Materijali i metode: Provedeno je retrospektivno istraživanje u kojem je uključena sva
dojenčad liječena u Klinici za dječje bolesti KBC-a Split u razdoblju od 1. siječnja 2018. do 31.
prosinca 2021. pod dijagnozom ALRI. Prikazali smo ukupan broj oboljelih, broj RSV
testiranih, broj RSV pozitivnih, težinu kliničke slike, epidemiološku sliku pojavnosti ALRI i
RSV-a, demografske karakteristike, način prehrane dojenčadi, korištenje antibiotske terapije i
duljinu trajanja hospitalizacije.
Rezultati: U istraživanje je uključeno 669 pacijenta od kojih je 364 (54,4%)
hospitalizirano prije, a 305 (45,6%) tijekom COVID pandemije. Između promatranih razdoblja
utvrdili smo statistički značajnu razliku u dobnim skupina oboljelih (P<0,001). Tijekom
pandemije broj RSV testirane dojenčadi iznosio je 277 (90,8%), a u pre-COVID periodu 271
(74,4%). Broj RSV pozitivne djece iznosio je 136 (50,2%) za prijepandemijski i 126 (45,5%)
za pandemijski period. Između navedenih razdoblja pronađena je statistički značajna razlika u
broju RSV testirane (P<0,001), ali ne i RSV pozitivne dojenčadi (P=0,240). U oba razdoblja
najveći broj djece prezentirao se kliničkom slikom blage infekcije, no tijekom pandemije
zabilježili smo porast broja hospitaliziranih zbog ozbiljne i vrlo ozbiljne infekcije. Analizom je
utvrđena statistički značajna razlika u težini kliničke slike oboljele dojenčadi (P=0,014).
Također, pandemija SARS–CoV–2 i stroge epidemiološke mjere dovele su do pada inicidencije
ALRI kao i promjene sezonalnosti RSV-a. Razdiobom po spolu utvrđena je veća stopa
hospitalizacije muške dojenčadi, njih 217 (59,6%) u pre-COVID i 172 (56,4%) u COVID
periodu. Prosječna duljina trajanja hospitalizacije iznosila je 5,99 ± 3,6 dana u
prijepandemijskom, a 6,97 ± 4,19 u pandemijskom razdoblju. Pronađena je statistički značajna
razlika u duljini trajanja hospitalizacije oboljele dojenčadi (P<0,001).
Zaključak: Provođenje strogih epidemioloških mjera i razdoblje zatvaranja utjecalo je
na promjenu sezonalnosti RSV kao jednog od najčešćeg uzročnika ALRI u djece. U našem
istraživanju zabilježen je pad broja hospitaliziranih, kašnjenje sezone RSV-a te pojava RSV
pozitivne dojenčadi u razdoblju ljetnih i ranih jesenskih mjeseci. Također, klinička slika
oboljele dojenčadi u razdoblju pandemije bila je teža što se očitovalo i na dulje trajanje
hospitalizacije. |
| Abstract (english) | Objectives: The aim of this study was to present demographic and clinical characteristics of
infants hospitalized because of ALRI before and during COVID pandemic.
Subjects and methods: A retrospective study was conducted in which we included
hospitalized infants with diagnosis of ALRI treated in Department of Pediatrics, University
Hospital of Split in period from January 1st 2018 to December 31st 2021. We analyzed: total
number of ALRI, number of RSV tested and RSV positive, severity of infection,
epidemiological picture of all ALRI and RSV, demographic characteristics (sex, GA, birth
weight and hight, number of preterm infants by GA, age, weight and hight in time of
hospitalization), diet, antibiotics used in treatment and lenght of hospitalization.
Results: The study included 669 patients, out of whom 364 (54.4%) were hospitalized during
pre-pandemic and 305 (45.6%) during pandemic period. We found statistically significant
difference between age groups among hospitalized with these two periods (P<0.001). The
number of RSV tested infants was 277 (90.8%) during pandemic and 271 (74.4%) in pre-
COVID period. The number of RSV positive was 136 (50.3%) in pre-pandemic and 126
(45.6%) in pandemic period. A statistically significant difference was found in total number
RSV tested (P<0.001) but not RSV positive (P=0.240). In both periods, most children had mild
infection, but during pandemic there was increase in number of infants with diagnose severe or
very severe illness. A statistically significant difference was found in severity of infection
(P=0.014). Also, pandemic of SARS–CoV–2 and epidemiological measures led to a decline in
incidence of ALRI as well as changes in the seasonality of RSV. The length of hospitalization
before pandemic was 5.99 ± 3.60 and during pandemic 6.97 ± 4.19 days. A statistically
significant difference in length of hospitalization between these two period was found
(P<0.001).
Conclusion: Implementation of strict epidemiological measures and lockdown changed the
seasonality of RSV as one of the most common causes of ALRI in children. In our research
there was decrease in number of hospitalized, delayed RSV season and the occurrence of RSV
positive infants in summer and early autumn months. Also during pandemic there was higher
number of infants with clinical presentation of severe and very severe infection which is in
correlation with longer duration of hospitalization. |
