Unique Changes in the Incidence of Acute Chest Syndrome in Children With Sickle Cell Disease Unravel the Role of Respiratory Pathogens

Assad, Zein; Valtuille, Zaba; Rybak, Alexis; Kaguelidou, Florentia; Lazzati, Andrea; Varon, Emmanuelle; Pham, Luu-Ly; Lenglart, Léa; Faye, Albert; Caseris, Marion; Cohen, Robert; Lévy, Corinne; Vabret, Astrid; Gravey, François; Angoulvant, François; Koehl, Bérengère; Ouldali, Naïm

doi:10.1016/j.chest.2023.07.4219

Cited by 5 publications

(2 citation statements)

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“…Secondary outcomes were the monthly incidence of HSP by age groups (≤5 years, 6-10 years, and 11-17 years). As a control outcome, we analyzed the monthly incidence of acute pyelonephritis per 100 000 children over the same period to assess the risk of bias due to potential hidden cointerventions, mainly a potential change in hospital admission capacities during the SARS-CoV-2 pandemic …”

Section: Methodsmentioning

confidence: 99%

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Common Seasonal Pathogens and Epidemiology of Henoch-Schönlein Purpura Among Children

Felix,

Assad,

Bidet

et al. 2024

JAMA Netw Open

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ImportanceHenoch-Schönlein purpura (HSP) is the most common type of vasculitis in children. The factors that trigger the disease are poorly understood. Although several viruses and seasonal bacterial infections have been associated with HSP, differentiating the specific associations of these pathogens with the onset of HSP remains a challenge due to their overlapping seasonal patterns.ObjectiveTo analyze the role of seasonal pathogens in the epidemiology of HSP.Design, Setting, and ParticipantsThis cohort study comprised an interrupted time-series analysis of patient records from a comprehensive national hospital-based surveillance system. Children younger than 18 years hospitalized for HSP in France between January 1, 2015, and March 31, 2023, were included.ExposureImplementation and relaxation of nonpharmaceutical interventions (NPIs) for the COVID-19 pandemic, such as social distancing and mask wearing.Main Outcomes and MeasuresThe main outcomes were the monthly incidence of HSP per 100 000 children, analyzed via a quasi-Poisson regression model, and the estimated percentage of HSP incidence potentially associated with 14 selected common seasonal pathogens over the same period.ResultsThe study included 9790 children with HSP (median age, 5 years [IQR, 4-8 years]; 5538 boys [56.4%]) and 757 110 children with the infectious diseases included in the study (median age, 0.7 years [IQR, 0.2-2 years]; 393 697 boys [52.0%]). The incidence of HSP decreased significantly after implementation of NPIs in March 2020 (−53.6%; 95% CI, −66.6% to −40.6%; P &lt; .001) and increased significantly after the relaxation of NPIs in April 2021 (37.2%; 95% CI, 28.0%-46.3%; P &lt; .001). The percentage of HSP incidence potentially associated with Streptococcus pneumoniae was 37.3% (95% CI, 22.3%-52.3%; P &lt; .001), the percentage of cases associated with Streptococcus pyogenes was 25.6% (95% CI, 16.7%-34.4%; P &lt; .001), and the percentage of cases associated with human rhino enterovirus was 17.1% (95% CI, 3.8%-30.4%; P = .01). Three sensitivity analyses found similar results.Conclusions and RelevanceThis study found that significant changes in the incidence of HSP simultaneously with major shifts in circulating pathogens after NPIs for the COVID-19 pandemic indicated that approximately 60% of HSP incidence was potentially associated with pneumococcus and group A streptococcus. This finding suggests that preventive measures against these pathogens could reduce the incidence of pediatric HSP.

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Section: Methodsmentioning

confidence: 99%

“…We organized the study into 3 periods according to the NPIs applied in France to counter the SARS-CoV-2 pandemic, as previously published. 14 The pre-NPI period was from January 2015 to March 2020, the NPI period was from April 2020 to March 2021, and the lifting of NPIs was from April 2021 to March 2023.…”

Section: Methodsmentioning

confidence: 99%