Effects of COVID-19-targeted nonpharmaceutical interventions on children's respiratory admissions in China: a national multicenter time series study

Objectives: To estimate the impact of nonpharmaceutical interventions (NPIs) targeted at the COVID-19 pandemic on the admission number of respiratory diseases, including pneumonia, acute bronchitis & bronchiolitis, and acute upper respiratory infections (AURIs) for children in China.Methods: Continuous hospitalization records aged 0-18 years from January 1, 2016, to December 31, 2020, were collected from 26 tertiary children's hospitals. Interrupted time series analysis with a quasi-Poisson model was conducted with the start time of the COVID-19 pandemic as the interrupted timepoint and the weekly admission numbers of all-cause respiratory disease, pneumonia, acute bronchitis & bronchi-olitis, and AURI as the outcome measures. Hospitalizations of childhood neoplasms were analyzed as the reference group.Results: The reduction in admission numbers following NPIs was-55.0% (-57.9 to-51.9%) for all-cause respiratory diseases,-62.7% (-65.7 to-59.5%) for pneumonia,-48.1% (-53.3 to-42.3%) for bronchitis & bronchiolitis, and-24.3% (-28.6 to-19.8%) for AURI. The effect estimates of NPIs on childhood neoplasms was-29.1% (-33.6 to-24.4%). Stratification analysis showed the reduction was most drastic for children at 4-6 and 7-12 years.Conclusion: The admission number for respiratory diseases among children in China decreased drasti-cally after the implementation of NPIs. NPIs with low socio-economic burdens should be suggested even outside the COVID-19 pandemic.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )