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Surge of Pediatric Respiratory Tract Infections After the COVID-19 Pandemic and the Concept of "Immune Debt"

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dc.authorscopusid57412856800
dc.authorscopusid8645663300
dc.authorscopusid57159456300
dc.authorscopusid21741757100
dc.authorscopusid36607486700
dc.authorscopusid55965490500
dc.authorscopusid36899126100
dc.authorwosidGuedj, Romain/Aae-1419-2021
dc.authorwosidGreber-Platzer, Susanne/Aat-1972-2021
dc.authorwosidBorensztajn, Dorine/Hmp-0277-2023
dc.authorwosidAssad, Zein/Hko-1924-2023
dc.authorwosidJankauskaite, Lina/I-8213-2019
dc.authorwosidOzkan, Esra/Kyp-1856-2024
dc.authorwosidJankauskaite, Lina/M-8043-2018
dc.contributor.authorLenglart, Lea
dc.contributor.authorTitomanlio, Luigi
dc.contributor.authorBognar, Zsolt
dc.contributor.authorBressan, Silvia
dc.contributor.authorBuonsenso, Danilo
dc.contributor.authorDe, Tisham
dc.contributor.authorPISODES Study Grp, E. P. I. S. O. D. E. S. Study Group
dc.contributor.authorIDSchaffert, Matthias/0000-0003-2594-8888
dc.contributor.authorIDNijman, Ruud Gerard/0000-0001-9671-8161
dc.contributor.authorIDBarrett, Michael/0000-0003-1775-8347
dc.contributor.authorIDRoland, Damian/0000-0001-9334-5144
dc.contributor.authorIDLeite-Almeida, Laura/0000-0003-2319-1332
dc.contributor.authorIDBarrett, Michael/0000-0003-1775-8347
dc.contributor.authorIDDurnin, Sheena/0000-0002-5109-3417
dc.date.accessioned2025-12-11T01:39:57Z
dc.date.issued2025
dc.departmentOndokuz Mayıs Üniversitesien_US
dc.department-temp[Lenglart, Lea; Titomanlio, Luigi] Paris Univ Cite, Robert Debre Univ Hosp, AP HP, Pediat Emergency Dept, Paris, France; [Titomanlio, Luigi] Paris Cite Univ, INSERM, U1141, DHU Protect, Paris, France; [Bognar, Zsolt] Heim Pal Natl Pediat Inst, Pediat Dept, Budapest, Hungary; [Bressan, Silvia; Tirelli, Francesca] Childrens Hlth Univ Hosp Padova, Dept Womens, Div Pediat Emergency Med, Padua, Italy; [Buonsenso, Danilo] Fdn Policlin Univ A Gemelli IRCCS, Dept Woman & Child Hlth & Publ Hlth, Rome, Italy; [De, Tisham; Nijman, Ruud G.] Imperial Coll London, Fac Med, Dept Infect Dis, Sect Paediat Infect Dis, London, England; [Farrugia, Ruth] Mater Dei Hosp, Dept Child & Adolescent Hlth, Msida, Malta; [Honeyford, Kate] Inst Canc Res, Div Clin Studies, Hlth Informat Team, London, England; [Maconochie, Ian K.; Nijman, Ruud G.] Imperial Coll Healthcare NHS Trust, Dept Emergency Med, St Marys Hosp, London, England; [Maconochie, Ian K.; Nijman, Ruud G.] Imperial Coll London, Fac Med, Ctr Pediat & Child Hlth, London, England; [Moll, Henriette A.; Oostenbrink, Rianne] ErasmusMC Sophia, Dept Gen Pediat, Rotterdam, Netherlands; [Parri, Niccolo] Osped Pediatr Meyer Firenze, Emergency Dept & Trauma Ctr, Florence, Italy; [Roland, Damian] Univ Leicester, SAPPHIRE Grp, Hlth Sci, Leicester, Leics, England; [Roland, Damian] Leicester Hosp, Pediat Emergency Med Leicester Acad PEMLA Grp, Leicester, England; [Ozkan, Esra Akyuz] Ondokuz Mayis Univ, Pediat Emergeny Dept, Samsun, Turkiye; [Almeida, Laura] Univ Porto, Ctr Hosp Univ Sao Joao, Porto, Portugal; [Alberti, Ilaria; Milani, Gregorio P.] Fdn IRCCS CaGranda Osped Maggiore Policlin, Pediat Emergency Dept, Milan, Italy; [Alberti, Ilaria; Milani, Gregorio P.] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy; [Angoulvant, Francois] Paris Sorbonne Univ, Ctr Rech Cordeliers, INSERM, Ctr Rech Cordeliers,UMRS 1138, Paris, France; [Assad, Zein; Nijman, Ruud G.] Paris Cite Univ, Robert Debre Univ Hosp, Dept Gen Pediat Pediat Infect Dis & Internal Med, Paris, France; [Aupiais, Camille] Jean Verdier Hosp, Pediat Emergency Dept, Sorbonne Paris Cite, AP HP, Paris, France; [Aupiais, Camille] Univ Paris, INSERM, ECEVE, UMR 1123, Paris, France; [Barrett, Michael] Pediat Emergency Dept, Childrens Hlth Ireland Crumlin, Dublin, Ireland; [Barrett, Michael] Univ Coll Dublin, Womens & Childrens Hlth, Dublin, Ireland; [Basmaci, Romain] Univ Paris, Louis Mourier Hosp, AP HP, Pediat Emergency Dept, Paris, France; [Borensztajn, Dorine] NoordWest Ziekenhuisgroep, Dept Pediat, Alkmaar, Netherlands; [Castanhinha, Susana] Hosp Dona Estefania, Ctr Hosp Lisboa Cent, Lisbon, Portugal; [Cohen, Robert] Univ Paris Est, Ctr Hosp Intercommunal, Res Ctr, Assoc Clin & rapeut Infantile Val Demarne ACTIV 28, Fosse, France; [Durnin, Sheena] Childrens Hlth Ireland Tallaght, Dept Pediat Emergency Med, Baile Atha Cliath, Ireland; [Fitzpatrick, Patrick] Childrens Hlth Ireland, Pediat Emergency Dept, Temple St, Dublin, Ireland; [Greber-Platzer, Susanne] Med Univ Vienna, Dept Pediat & Adolescent Med, Clin Div Pediat Pulmonol, Pediat Emergency Unit, Vienna, Austria; [Guedj, Romain] Sorbonne Univ, Armand Trousseau Hosp, Pediat Emergency Dept, Epop Team, CRESS Inserm, Paris, France; [Hey, Florian] Ludwig Maximilians Univ Munchen, Dr Hauner Childrens Hosp, Emergency Dept, Pediat Intens Care Unit, Munich, Germany; [Jankauskaite, Lina] Lithuanian Univ Hlth Sci, Dept Pediat, Kaunas, Lithuania; [Keitel, Kristina] Kinderklin Inselspital, Bern, Switzerland; [Mascarenhas, Ines] Hosp Prof Doutor Fernando Fonseca, Dept Crianc & Jovem Urgencia Pediat, Amadora, Portugal; [Musolino, Anna Maria; Supino, Maria Chiara] IRCCS, Bambino Gesu Childrens Hosp, Emergency Dept, Rome, Italy; [Pucuka, Zanda] Childrens Clin Univ Hosp, Riga Stradins Univ, Paediat Emergency Dept, Riga, Latvia; [Rinder, Malin Ryd] Karolinska Univ Hosp, Astrid Lindgrens Childrens Hosp, Pediat Emergency Dept, Stockholm, Sweden; [Ouldali, Naim] INSERM, Infect Antimicrobials Modelling Evolut IAIME, UMR 1137, Paris, Franceen_US
dc.descriptionSchaffert, Matthias/0000-0003-2594-8888; Nijman, Ruud Gerard/0000-0001-9671-8161; Barrett, Michael/0000-0003-1775-8347; Roland, Damian/0000-0001-9334-5144; Leite-Almeida, Laura/0000-0003-2319-1332; Barrett, Michael/0000-0003-1775-8347; Keitel, Kristina/0000-0002-9663-3843; Lenglart, Lea/0000-0003-2325-8998; Silva Costa, Inês/0000-0002-2940-838X; Jankauskaite, Lina/0000-0002-6997-4917; Durnin, Sheena/0000-0002-5109-3417en_US
dc.description.abstractObjective To investigate a dose-response relationship between the magnitude of decrease in pediatric respiratory tract infections (RTIs) during the 2020 implementation of nonpharmaceutical interventions (NPIs) and the increase thereafter during NPI lifting. Study design We conducted an interrupted, time-series analysis based on a multinational surveillance system. All patients <16 years of age coming to medical attention with various symptoms and signs of RTI at 25 pediatric emergency departments from 13 European countries between January 2018 and June 2022 were included. We used generalized additive models to correlate the magnitude of decrease of each RTI during NPI (such as social distancing) implementation and its subsequent increase during NPI lifting. Urinary tract infections served as control outcome. Results In total, 528 055 patients were included. We observed reductions in cases during the NPI period, from-76% (95% CI-113 to-53 in pneumonia) to-65% (95% CI-100 to-39 for tonsillitis/pharyngitis), followed by strong increases during NPI lifting, from +83% (95% CI 29-150 for tonsillitis/pharyngitis) to +329% (95% CI 149-517 for bronchiolitis). For each RTI, we found a significant association between the magnitude of decrease during NPI implementation and the increase during NPI lifting. Urinary tract infection cases remained stable. Conclusions The magnitude of increase in RTI observed after NPI lifting was directly correlated to the magnitude of case reduction during NPI implementation, suggesting a "dose-response" relationship from an "immune debt" phenomenon. The likely rebound in RTIs should be expected when implementing and lifting NPI in the future.en_US
dc.description.sponsorshipGSK; Sanofien_US
dc.description.sponsorshipfunding. N.O. reports travel grants from Pfizer, GSK, and Sanofi. No other authors have conflicts of interest to disclose.r funding. N.O. reports travel grants from Pfizer, GSK, and Sanofi. No other authors have conflicts of interest to disclose.en_US
dc.description.woscitationindexScience Citation Index Expanded
dc.identifier.doi10.1016/j.jpeds.2024.114420
dc.identifier.issn0022-3476
dc.identifier.issn1097-6833
dc.identifier.pmid39579868
dc.identifier.scopus2-s2.0-105007879352
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1016/j.jpeds.2024.114420
dc.identifier.urihttps://hdl.handle.net/20.500.12712/45258
dc.identifier.volume284en_US
dc.identifier.wosWOS:001509189600003
dc.identifier.wosqualityQ1
dc.language.isoenen_US
dc.publisherMosby-Elsevieren_US
dc.relation.ispartofJournal of Pediatricsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleSurge of Pediatric Respiratory Tract Infections After the COVID-19 Pandemic and the Concept of "Immune Debt"en_US
dc.typeArticleen_US
dspace.entity.typePublication

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