Hospital Admissions For Respiratory Infections Research Articles

Pediatric hospital admissions, case severity, and length of hospital stay during the first 18 months of the COVID-19 pandemic in a tertiary children’s hospital in Switzerland

BackgroundSARS-CoV-2 directly contributes to the burden of respiratory disease in children, but indirect effects of protective measures also need to be considered to assess the overall impact of the pandemic on children's health.MethodsWe retrospectively compared pre-pandemic and pandemic data of main admission diagnoses, sorted by ICD-10 diagnosis groups, in a tertiary children's hospital in Switzerland from 2017 until August 2021. Hospital admission rates, severity, and length of stay (LOS) of the individual ICD-10 groups during the pandemic were compared with three previous years accounting for seasonal differences.ResultsAmong 20,168 hospital admissions (n = 13′950 in pre-pandemic years; n = 3′120 in 2020 and n = 3′098 in 2021), there were significant decreases in numbers of admissions for respiratory diseases during the early pandemic with a rebound in summer 2021. During the pandemic, admissions for non-respiratory infections, neoplasms, and skin diseases decreased but increased for trauma. Particularly, a drop in admissions for different respiratory infections [e.g. respiratory syncytial virus (RSV) and bronchiolitis] was pronounced after introduction of strict measures, but admissions increased again after restrictions were loosened. While disease severity was lower for respiratory and neurologic diseases and bronchiolitis throughout the pandemic, gastrointestinal disease admissions had longer LOS and in the first pandemic year greater severity. For RSV and pneumonia, disease severity and LOS were higher in the first pandemic year and lower in the second pandemic year.ConclusionThe pandemic and associated protective measures had a significant effect on respiratory and non-respiratory admissions, particularly with decreases in hospital admissions for respiratory infections followed by a rebound after loosening of measures.

Air pollution and hospital admissions and deaths due to respiratory infections in megacity of Tehran: A time series analysis

Introduction: Air pollution is one of the main causes for the significant increase of respiratory infections in Tehran. In the present study, we investigated the associations between short-term exposure to ambient air pollutants with the hospital admissions and deaths. Materials and methods: Health data from 39915 hospital admissions and 2459 registered deaths associated with these hospital admissions for respiratory infections were obtained from the Ministry of Health and Medical Education during 2014-2017. We used the distributed lag non-linear model (DLNM) for the analyses. Results: There was a statistically positive association between PM2.5 and AURI in the age group of 16 years and younger at lags 6 (RR 1.31; 1.05-1.64) and 7 (RR 1.50; 1.09-2.06). AURI admissions was associated with O3 in the age group of 16 and 65 years at lag 7 with RR 1.13 (1.00-1.27). ALRI admissions was associated with CO in the age group of 65 years and older at lag 0 with RR 1.12 (1.02-1.23). PM10 was associated with ALRI daily hospital admissions at lag 0 for males. ALRI admissions were associated with NO2 for females at lag 0. There was a positive association between ALRI deaths and SO2 in the age group of 65 years and older at lags 4 and 5 with RR 1.04 (1.00-1.09) and 1.03 (1.00-1.07), respectively. Conclusion: Exposure to outdoor air pollutants including PM10, PM2.5, SO2, NO2, O3, and CO was associated with hospital admissions for AURI and ALRI at different lags. Moreover, exposure to SO2 was associated with deaths for ALRI.

Effects of temperature on hospitalisation among pre-school children in Hanoi, Vietnam.

This study examined the effect of short-term changes in ambient temperature on hospital admissions among children aged less than 5years old in Hanoi, Vietnam. Data on daily hospital admissions from January 2010 to June 2014 were collected from two hospitals. Daily meteorological data were obtained for the same period. We applied time series analysis to evaluate the risk of hospitalisation related to hot and cold weather by age and causes. We found that a 1°C decrease in minimum temperature during the cold weather months was associated with 2.2% increase in hospital admission for respiratory infection among children 3-5years old. A 1°C increase in diurnal temperature range (DTR) in cold weather was associated with an increase of 1.9% and 1.7% in hospitalisation for all causes and respiratory infection, respectively, among children < 3years old and an increase of 1.8% and 3.4% in hospitalisation for all causes and respiratory infection, respectively, among children of 3-5years old. Negative associations between hot weather and hospital admissions were demonstrated. These findings suggested that low temperature and DTRs in winter are important risk factors for hospital admissions among children aged < 5years old in Hanoi. Other factors may have modified the effect of high temperature on hospital admissions of children in Hanoi.

모유 수유와 멜라토닌

Breastfeeding is highly recommended due to its benefits for both the infant and mother; however, most mothers predominantly use formula feed. Breastfeeding affords protection against a wide variety of medical conditions that may emerge at different time points over the lifespan, including hospital admissions for respiratory infections and neonatal fever, offspring childhood obesity, and cancer as well as cardiovascular disease, hyperlipidemia, hypertension, and diabetes. Moreover, breastfeeding is expected to decrease the risk of adolescent depression and other psychopathologies. It is also important for the development of the gut, gut-brain axis, and immune system, and night-time breast milk is likely to have higher antioxidant, anti-inflammatory, and immune regulatory effects due to the impact of breast milk melatonin on the infant

Vitamin D Levels in Premature Children Admitted to the Hospital with Viral Respiratory Infection.

Children born preterm are at risk of hospital admission for respiratory infection in the first years of life. Vitamin D deficiency has been associated with increased risk of developing lower respiratory tract infection (LRTI). We assessed vitamin D levels in children born preterm admitted to the hospital ward or pediatric intensive care unit (PICU) with viral LRTI. A prospective observational cohort study was conducted over 3 years that enrolled 87 children <3 years of age, born <37 weeks of gestation. Children were enrolled in the ward and PICU if they had a diagnosis of LRTI with confirmed viral testing. Children seen in the outpatient clinic for well-child care were enrolled as study controls. Vitamin D and cathelicidin levels were measured and associations between vitamin D, cathelicidin, and admission sites were tested. Vitamin D levels were lower in children admitted to the PICU when compared to controls (28 ng/mL versus 36 ng/mL; P < 0.03) but were not different between children admitted to the ward or PICU. Overall, vitamin D levels were lower in children born late preterm (≥34 weeks, LPT) when compared to those born early preterm (<34 weeks, EPT), (28 ng/mL versus 34 ng/mL; P = 0.016), and EPT children were more likely to receive multivitamin supplementation before admission. Vitamin D levels in children born prematurely, admitted to the PICU, were lower than in controls. Overall levels were lower in LPT infants and this group did not receive multivitamin supplementation as much as those considered EPT. Prior research has shown associations between low vitamin D levels and respiratory disease. To our knowledge, this is the first study showing an association between low vitamin D levels and severity of respiratory disease, specifically in preterm children. Further, we found that late preterm children have lower levels of vitamin D and less frequent multivitamin supplementation.

Impact of respiratory infections, outdoor pollen, and socioeconomic status on associations between air pollutants and pediatric asthma hospital admissions.

BackgroundEpidemiology studies have shown that ambient concentrations of ozone and fine particulate matter (PM2.5) are associated with increased emergency department (ED) visits and hospital admissions (HAs) for asthma.ObjectiveEvaluate the impact of outdoor pollen, respiratory infections, and socioeconomic status (SES) on the associations between ambient ozone and PM2.5 and asthma HAs in New York City.MethodsDaily ozone, PM2.5, meteorological factors, pollen, and hospitalization records during 1999 to 2009 were obtained for New York City residents. Daily counts of HAs for asthma and respiratory infections were calculated for all-age and specific age groups, and for high- and low-SES communities. Generalized additive models were used to examine ambient concentrations of ozone and PM2.5 and asthma HAs, potential confounding effects of outdoor pollen and HAs for respiratory infections, and potential effect modification by neighborhood SES.ResultsBoth ozone and PM2.5 were statistically significantly associated with increased asthma HAs in children aged 6–18 years (per 10 ppb increase in ozone: RR = 1.0203, 95% CI: 1.0028–1.0382; per 10 μg/m3 increase in PM2.5: RR = 1.0218, 95% CI: 1.0007–1.0434), but not with total asthma HAs, or asthma HAs in other age groups. These associations were stronger for children living in the high-SES areas. Adjustment for respiratory infection HAs at various lags did not result in changes greater than 10% in the risk estimates for either ozone or PM2.5. In contrast, adjustment for outdoor pollen generally attenuated the estimated RRs for both ozone and PM2.5.ConclusionsAmbient ozone and PM2.5 are associated with asthma HAs in school-age children, and these associations are not modified by SES. HAs for respiratory infections do not appear to be a confounder for observed ozone- and PM2.5-asthma HAs associations, but pollen may be a weak confounder.

Breast-feeding and Childhood Hospitalizations for Infections

Infectious disease is a leading cause of morbidity and hospitalization for infants and children. During infancy, breast-feeding protects against infectious diseases, particularly respiratory infections, gastrointestinal infections, and otitis media. Little is known about the longer-term impact of breast-feeding on infectious disease in children. We investigated the relationship between infant feeding and childhood hospitalizations from respiratory and gastrointestinal infections in a population-based birth cohort of 8327 children born in 1997 and followed for 8 years. The main outcomes were public hospital admissions for respiratory infections, gastrointestinal infections, and all infectious diseases. Cox regression was used to assess time to first hospitalization. Breast-feeding only (no formula-feeding) for 3 or more months was associated with a lower risk of hospital admission in the first 6 months of life for respiratory infections (hazard ratio = 0.64 [95% confidence interval = 0.42-0.97]), gastrointestinal infections (0.51 [0.25-1.05]), and any infection (0.61 [0.44-0.85]), adjusted for sex, type of hospital at birth, and household income. Partial breast-feeding (both breast-feeding and formula-feeding) in the first 3 months also reduced hospitalizations from infections but with smaller effect sizes. Beyond 6 months of age, there was no association between breast-feeding status at 3 months and hospitalization for infectious disease. Giving breast milk and no formula for at least 3 months substantially reduced hospital admissions for many infectious diseases in the first 6 months of life, when children are most vulnerable.

Infecciones respiratorias y cardiopatías congénitas: dos estaciones del estudio CIVIC

In younger than 24 month with significant congenital heart disease we evaluate the hospitalisation rate for acute respiratory tract infection, the associated risk factors, compliance of preventive measures, aetiology and clinical course. Ours was an epidemiological, multicentric (53 Spanish hospitals), observational and prospective study, in two seasons from October to April from 2004 to 2006. 1248 patients were follow-up. 167 patients (13.4 %, 95 % CI: 11.6-15.4 %) required 210 hospitalizations for respiratory infection. Significant risk factors were with Odds ratio: Delection 22q11 4.31, sibilances 4.25, incomplete prophylaxis against respiratory syncytial virus 2.10, sibblings less than 11 years old 2.06, trisomy 21 1.89, second season 1.74, prematurity 1.54. Protective factors were: weight over third percentile 0.57, female 0.65 and age in months 0.94. The main diagnosis were bronchiolitis (41.7 %), upper respiratory airway infection (28,1 %) and pneumoniae (17.6 %). An infectious agent was found in 32.5 % cases. Respiratory syncytial virus was the principal agent founded with a 3.4 % specific rate. Median stay was 6 days. In 18.1 % episodes admission in intensive care unit was required. 4 patients (0.32 %) died from respiratory infection. We found 13.4 % in hospital admissions for respiratory infection. Significant risk factors are mainly associated (syndromes, malnutrition, siblings, incomplete respiratory syncytial virus prophylaxis). Bronchiolitis and respiratory syncytial virus was the most common clinical picture and identified infectious agent. In some cases they are morbidity and mortality.

Ambulatory Antibiotic Prescribing for Acute Bronchitis and Cough and Hospital Admissions for Respiratory Infections: Time Trends Analysis

To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory infections for adults between 1996 and 2003 in the USA. USA: ambulatory prescribing behaviour was derived from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey while hospitalizations in acute care hospitals were assessed in the National Hospital Discharge Survey. Adults 18-64 years old. None. Proportion of visits for acute bronchitis/cough receiving a prescription for antibiotics and hospitalization for respiratory infections. Ambulatory antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections exhibited non-linear patterns over the 8 year period. However, antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections had a weak/moderate negative association. For three of the seven yearly changes in prescribing and hospitalizations as one increased the other decreased (P<0.01). Ambulatory antibiotic prescribing for respiratory tract infections was inversely associated with hospital admissions for respiratory tract infections.

Ambulatory antibiotic prescribing for acute bronchitis and cough and hospital admissions for respiratory infections: time trends analysis

To examine the relationship between ambulatory antibiotic prescribing for acute bronchitis and cough with hospital admissions for respiratory infections in the USA between 1996 and 2003. Analysis of data on antibiotic prescribing for episodes of acute bronchitis/cough illness in ambulatory care and hospitalization for respiratory infections for adults between 1996 and 2003 in the USA. USA: ambulatory prescribing behaviour was derived from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey while hospitalizations in acute care hospitals were assessed in the National Hospital Discharge Survey. Adults 18-64 years old. None. Proportion of visits for acute bronchitis/cough receiving a prescription for antibiotics and hospitalization for respiratory infections. Ambulatory antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections exhibited non-linear patterns over the 8 year period. However, antibiotic prescribing practices for acute bronchitis/cough and hospitalizations for respiratory infections had a weak/moderate negative association. For three of the seven yearly changes in prescribing and hospitalizations as one increased the other decreased (P<0.01). Ambulatory antibiotic prescribing for respiratory tract infections was inversely associated with hospital admissions for respiratory tract infections.

Surveillance of respiratory virus infections in adult hospital admissions using rapid methods

Both influenza and respiratory syncytial virus (RSV) cause epidemics of respiratory illness of variable severity during the winter season. Influenza in particular has been blamed for hospital winter bed pressures, although it is thought that RSV may also play a role. Human metapneumovirus (hMPV) is a new respiratory virus reported to be important in children; only a limited number of studies are available for adult populations. We aimed to determine initially the burden of virologically confirmed infections, i.e. influenza, RSV and hMPV using polymerase chain reaction (PCR) technology and, in addition, to assess the feasibility of this approach as a surveillance tool for these respiratory viruses. Adult patients admitted to hospital in the previous 24 hours with onset of acute respiratory symptoms in the last 14 days were asked to participate. Informed written consent was obtained and nose and throat swabs taken. Multiplex PCR for influenza A (H1N1 and H3N2), influenza B and RSV A and B were carried out together with a separate PCR for hMPV. A total of 219 patients in 2001-2002 and 216 in 2002-2003 were tested and the combined results for both seasons were: 8 positive for influenza A/H1N1, 14 for influenza A/H3N2, 2 for influenza B, 14 for RSV A and 6 for RSV B. Most patients (261/435) were >65 years and most positives (30/44) were found within this age group. A number of patients aged >65 years who were positive for influenza (12/15) reported having had vaccine. In total, 373 samples were tested for hMPV and 20 were found positive across all age groups except the 45-54 years age group. As influenza activity was low during the study period the impact of infection on admissions could not be assessed. Nevertheless the viruses studied accounted for 15% of hospital admissions for respiratory infection. Most patients were aged >65 years, as expected. In the two years studied RSV and hMPV were each responsible for as many hospitalized cases of respiratory infection as influenza. Influenza infection must be considered even in those who give a history of vaccination. The molecular methods used in this study showed that surveillance of these respiratory viruses can be conducted and may help in the management of patients.

Social deprivation and hospital admission for respiratory infection:: an ecological study

Study objective: To examine the relationship between social deprivation and risk of hospital admission for respiratory infection. Methods and subjects: Ecological study using hospital episode statistics and population census data. Cases were residents of the West Midlands Health Region admitted to hospital with a diagnosis of respiratory infection, acute respiratory infection, pneumonia or influenza over a 5-year period. Postcodes of cases were used to assign Townsend deprivation scores; these were then ranked and divided into five deprivation categories. Poisson regression analysis was used to estimate the magnitude of effect for associations between deprivation category and hospital admission by age and admitting diagnosis. Main results: There were 136 755 admissions for respiratory infection, equivalent to an annual admission rate of 27.1 per 1000 population (95% CI=26.9–27.2). Deprivation was associated with increased admission rates for all respiratory infection ( P<0.0001) and affected all age-groups. The greatest effect was in the 0–4 years age-group with admission rates 91% higher in the most deprived children compared to the least deprived. Hospital admissions for acute respiratory infection and pneumonia were both significantly associated with deprivation ( P<0.0001). Conclusions: Respiratory infection is associated with social inequalities in all age-groups, particularly in children. Prevention of respiratory infection could make an important contribution to reducing health inequalities.