| 摘要: |
| 目的 分析新型冠状病毒肺炎（COVID-19）疫情暴发前、后儿科住院患儿疾病种类的变化。方法 收集海军军医大学（第二军医大学）第一附属医院儿科2019年2月－2020年1月（COVID-19疫情发生前1年）1 931例和2020年2月－2021年1月（COVID-19疫情发生后1年）618例住院患儿的性别、年龄、常住地、疾病诊断等相关信息，对疫情发生前、后1年住院患儿的总数、常住地、性别及各系统疾病的构成等进行统计分析。结果 COVID-19疫情发生后1年住院患儿数量减少68.00%（1 313/1 931）。疫情发生后1年常住地为外省市的患儿数量下降［17.80%（110/618）vs 29.00%（560/1 931）］，与疫情发生前1年相比，住院患儿常住地分布差异有统计学意义（P<0.01）。疫情发生后1年，呼吸系统疾病患儿减少92.04%（971/1 055），占比下降［13.59%（84/618）vs 54.63%（1 055/1 931）］；内分泌系统疾病患儿增加20.71%（29/140），占比上升［27.35%（169/618）vs 7.25%（140/1 931）］；新生儿疾病患儿减少43.01%（166/386），但占比上升［35.60%（220/618）vs 19.99%（386/1 931）］。与疫情发生前1年相比，疫情发生后1年住院患儿的呼吸系统疾病、内分泌系统疾病、新生儿疾病构成比差异均有统计学意义（P均<0.01）。疫情发生前、后1年住院患儿年龄分布（P<0.01）和各季节住院患儿数量（P<0.05）均不同。疫情发生后1年住院患儿中呼吸系统疾病患儿数量减少最为明显，肺炎患儿减少93.71%（655/699），疫情发生前、后1年肺炎占比差异有统计学意义［52.38%（44/84）vs 66.26%（699/1 055），P<0.05］。与疫情发生前1年相比，疫情发生后1年内分泌系统疾病中矮小症/生长发育迟缓占比减少、性早熟/青春期发育提前病例占比增加（P<0.05）。结论 COVID-19疫情导致儿科住院患儿明显减少，以呼吸系统疾病占比下降尤为显著，但内分泌系统疾病住院患儿增加，提示疫情防控措施可有效减少需住院治疗的呼吸系统疾病，但同时导致性早熟、青春期发育提前患儿增多，需引起综合医院儿科的重视。 |
| 关键词: 新型冠状病毒肺炎 儿科学 住院患儿 疾病谱 |
| DOI：10.16781/j.CN31-2187/R.20210438 |
| 投稿时间：2021-04-25修订日期：2021-08-11 |
| 基金项目: |
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| Analysis of disease spectrum of hospitalized children during outbreak of coronavirus disease 2019 in pediatric department of a tertiary general hospital in Shanghai |
| GAO Yu,GAN Lu,CAO Shi-yan,ZHOU Lin* |
(Department of Pediatrics, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To analyze the changes of disease spectrum in pediatric inpatients before and after the outbreak of coronavirus disease 2019 (COVID-19). Methods The data of gender, age, habitual residence, diagnosis and other relevant information of 1 931 hospitalized children in Department of Pediatrics, The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Feb. 2019 to Jan. 2020 (1 year before the COVID-19 epidemic) and 618 hospitalized children from Feb. 2020 to Jan. 2021 (1 year after the COVID-19 epidemic) were collected. The total number, habitual residence, gender and disease spectrum of hospitalized children 1 year before and 1 year after the COVID-19 epidemic were statistically analyzed. Results The number of hospitalized children decreased by 68.00% (1 313/1 931) 1 year after the COVID-19 epidemic. The number of hospitalized children from other provinces and cities was decreased (17.80%[110/618] vs 29.00%[560/1 931]) and there was significantly difference in the distribution of habitual residence of hospitalized children between 1 year before and 1 year after the COVID-19 epidemic (P<0.01). One year after the COVID-19 epidemic, the number of children with respiratory diseases decreased by 92.04% (971/1 055), and the proportion was also decreased (13.59%[84/618] vs 54.63%[1 055/1 931]); the number of children with endocrine system diseases increased by 20.71% (29/140), and the proportion was increased (27.35%[169/618] vs 7.25%[140/1 931]); the number of children with neonatal diseases decreased by 43.01% (166/386), but the proportion was increased (35.60%[220/618] vs 19.99%[386/1 931]). Compared with 1 year before the COVID-19 epidemic, there were significant differences in the proportions of respiratory diseases, endocrine system diseases and neonatal diseases in hospitalized children 1 year after the COVID-19 epidemic (all P<0.01). The age distribution of hospitalized children 1 year before and 1 year after the epidemic of COVID-19 was different (P<0.01), and the number of hospitalized children was also different in different seasons (P<0.05). One year after the epidemic of COVID-19, the number of hospitalized children with respiratory diseases was decreased most significantly, and the number of children with pneumonia decreased by 93.71% (655/699), with a significant difference found in the proportions of pneumonia between 1 year before and 1 year after the COVID-19 epidemic (52.38%[44/84] vs 66.26%[699/1 055], P<0.05). Compared with 1 year before the COVID-19 epidemic, the proportion of endocrine system diseases such as short stature/growth retardation was decreased and the proportion of precocious puberty/early puberty development was increased 1 year after the COVID-19 epidemic (P<0.05). Conclusion The COVID-19 epidemic has led to a significant decrease in hospitalized children in department of pediatric, especially in the proportion of respiratory diseases, but it has led to an increase in hospitalized children with endocrine system diseases, suggesting that epidemic prevention and control measures can effectively reduce respiratory diseases requiring hospitalization, but may increase precocious puberty and early puberty development. These changes should be considered by department of pediatrics in general hospitals. |
| Key words: coronavirus disease 2019 pediatrics hospitalized children disease spectrum |
