Impact of Pandemic Nonpharmacological Public Health Interventions in Response to COVID-19 on Hospitalizations for Pneumonia in Children in Brazil

Abstract

Background: The knowledge about the impact of the nonpharmacological measures to control the COVID-19 pandemic can give insight to ways in which they can also be applied for other respiratory diseases and therefore possibly help to reduce the burden of respiratory conditions in health systems. To assess the impact of containment measures of the COVID-19 pandemic on pneumonia hospitalizations in children from 0 to 14 years of age in Brazil.   Methods: Data from hospital admissions for pneumonia were obtained from the Department of Informatics of Brazilian Public Health System database in the period of 2015–2020 and analyzed by macro-regions and age groups. To evaluate the effect of containment measures, used in the pandemic, on the incidence of pneumonia, the absolute reduction (without - with pandemic containment measures) and relative reduction (without - with pandemic containment measures / without pandemic containment measures) were calculated by analyzing the subsets 2015-2019 vs 2020.   Findings: Comparing the subsets of April-August 2015-2019 vs April-August 2020, there was an expressive reduction in the average incidence of hospitalizations, with numbers ranging from -87% [IRR 0.12 (0.10 to 0.14)] for < 4 years, -79% [IRR 0.21 (0.07 to 0.57)] for 5-9 years, -73% [IRR 0.26 (0.05 to 1.21)] for 10-14 and -86% [IRR 0.14 (0.06 to 0.29)] for  <14 years. When comparing the subsets by macro-regions of Brazil (April-August 2015-2019 vs April-August 2020), a drop in hospitalizations was observed which ranged from -77% [IRR 0.23 (0.15 to 0.34)] in the Southeast to -87% [IRR 0.12 (0.07 to 0.21)] in the Northeast in children under 4 years. For children 5-9 years the fall ranged from -69% [IRR 0.30 (0.11 to 0.79)] in the Southeast region to -90% [IRR 0.10 (0.02 to 0.38)] in the South and in children 10-14 years, hospitalizations ranged from -73% [IRR 0.26 (0.05 to 1.21)] to -89% [IRR 0.19 (0.03 to 0.98)] in the South.   Interpretation: We found a significant decrease in cases of pneumonia during the COVID-19 pandemic. Nonpharmacological public health interventions can contribute to the decline of other respiratory infectious diseases. Funding: The present work was carried out with the support of the Coordination of Improvement of Personnel Higher Education - Brazil (CAPES) - Financing Code 001. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript. Declaration of Interest: None to declare.