Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Study Group
3.2. Clinical Presentation
3.3. Treatment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Total n = 221 | 2019 n = 59 | 2022 n = 162 | p Value (2019 vs. 2022) | |||
---|---|---|---|---|---|---|
Sex, n (%) | Male | 112 (51) | 29 (49) | 83 (51) | 0.78 | |
Female | 109 (49) | 30 (51) | 79 (49) | |||
Median age in years (IQR) | 3.5 (1.0; 6.0) | 3.0 (0.5; 5.4) | 4.0 (1.0–6.0) | 0.02 | ||
Infants, n (%) | 40 (18) | 16 (27.1) | 24(14.8) | 0.03 | ||
Ukrainian refugee, n (%) | 8 (3.6) | 0 | 8 (4.9) | 0.08 | ||
Month of infection, n (%) | Winter-spring (December–May) | 133 (60.2) | 46 (78) | 87 (53.7) | 0.0011 | |
Summer-fall (June–November) | 88 (39.8) | 13 (22) | 75 (46.3) | |||
Coronavirus disease 2019, n (%) | Vaccinated | Not applicable | 2 (1.2) | Not applicable | ||
Not vaccinated | 64 (39.5) | |||||
Not qualified for vaccination | 96 (59.3) | |||||
Varicella immunization, n (%) | Not vaccinated | 219 (99.1) | 58 (98.3) | 161 (99.4) | 0.45 | |
1 dose/postexposure | 2 (0.9) | 1 (1.7) | 1 (0.6) | |||
Fully vaccinated | 0 | 0 | 0 | |||
Immunosuppression, n (%) | 5 (2.3) | 2 (3.4) | 3 (1.9) | 0.49 | ||
Source of infection, n (%) | Unknown | 61 (27.6) | 11 (18.6) | 50 (30.9) | 0.007 | |
Household | 79 (35.7) | 23 (39) | 56 (34.6) | |||
Daycare/Schools.py | 73 (33) | 19 (32.2) | 54 (33.3) | |||
Refugee camp | 8 (3.6) | 6 (10.2) | 2 (1.3) | |||
Comorbidities, n (%) | 48 (21.7) | 14 (23.7) | 34 (21) | 0.66 |
Total (n = 221) | 2019 (n = 59) | 2022 (n = 162) | p Value (2019 vs. 2022) | ||
---|---|---|---|---|---|
General condition, n (%) | Good | 55 (24.9) | 15 (25.4) | 40 (24.7) | 0.52 |
Fair | 138 (62.4) | 39 (66.1) | 99 (61.1) | ||
Serious | 28 (12.7) | 5 (8.5) | 23 (14.2) | ||
Median Time of (in days), IQR | Lesions | 6 (5–8) | 6 (5–7) | 7 (5–8) | 0.17 |
Fever | 3 (1–4) | 2 (0–3) | 4 (2–5) | <0.0001 | |
hospitalization | 4 (4–6) | 4 (3–5) | 5 (4–7) | 0.01 | |
Skin complications, n (%) | 159 (71.9) | 31 (52.5) | 129 (79.6) | 0.0001 | |
Bacterial superinfection, n (%) | 156 (70.6) | 30 (50.8) | 126 (77.8) | 0.0001 | |
Etiology, n (%) | S. pyogenes | 29 (13.1) | 3 (5.1) | 26 (16.0) | 0.03 |
S. aureus | 27 (12.2) | 1 (1.7) | 26 (16.0) | 0.004 | |
S. pyogenes + S. aureus | 3 (1.4) | 0 | 3 (1.9) | 0.29 | |
Scarlet fever, n (%) | 40 (18.1) | 10 (16.9) | 30 (18.5) | 0.79 | |
Cellulitis, n (%) | 24 (10.9) | 2 (3.4) | 22 (13.6) | 0.03 | |
Sepsis, n (%) | 29 (13.1) | 2 (3.4) | 27 (16.7) | 0.009 | |
Neurological complications n (%) | Total | 12 (5.4) | 5 (8.5) | 7 (4.3) | 0.01 |
Meningitis | 0 | 0 | 0 | - | |
Cerebellitis | 6 (2.7) | 3 (5.1) | 3 (1.9) | 0.19 | |
encephalitis | 1 (0.5) | 0 | 1 (0.6) | 0.54 | |
Seizures | 5 (2.3) | 4 (6.8) | 1 (0.6) | 0.006 | |
Eye involvement, n (%) | 84 (38) | 21 (35.6) | 63(38.9) | 0.65 | |
Other complications, n (%) | Total | 58 (26.2) | 21 (35.6) | 37 (22.8) | 0.05 |
syncope/unconsciousness | 7 (3.2) | 2 (3.4) | 5 (3.1) | 0.9 | |
otitis media | 19 (8.6) | 7 (11.9) | 12 (7.4) | 0.29 | |
Pneumonia | 16(7.2) | 5 (8.5) | 11 (6.8) | 0.66 | |
Other | 13 (5.8) | 6 (1.0) | 7 (4.3) | 0.02 |
Total | 2019 | 2022 | p Value (2019 vs. 2022) | |
---|---|---|---|---|
Leukocytes Median (IQR) | 8.8 (6.7–12.3) | 9.5 (7.4–13.6) | 8.5 (6.5–11.9) | 0.13 |
CRP Median (IQR) | 14.0 (6.3–28.8) | 9.5 (6.0–30.0) | 16 (7.0–28.3) | 0.27 |
PCT Median (IQR) | 0.29 (0.16–0.88) | 0.26 (0.16–1.24) | 0.31 (0.16–0.87) | 0.79 |
Total (n = 221) | 2019 (n = 59) | 2022 (n = 162) | p Value (2019 vs. 2022) | ||
---|---|---|---|---|---|
Number of antibiotics, n (%) | None | 41 (18.6) | 17 (28.8) | 24 (14.8) | 0.01 |
One | 150 (67.9) | 40 (67.8) | 110 (67.9) | 0.98 | |
Two | 27 (12.2) | 2 (3.4) | 25 (15.4) | 0.01 | |
Three | 3 (1.3) | 0 | 3 (1.9) | 0.29 | |
Route of administration, n (%), | Oral | 20 | 7 | 13 | 0.19 |
Intravenous | 27 | 8 | 19 | 0.24 | |
Sequential | 133 | 27 | 106 | 0.10 | |
Acyclovir, n (%) | Total | 133 (60.1) | 33 (55.9) | 100 (61.7) | 0.43 |
Oral | 116 (52.5) | 24 (40.7) | 92 (56.8) | 0.01 | |
Intravenous | 10 (4.5) | 5 (8.5) | 5 (3.1) | ||
Sequential | 7 (3.2) | 4 (6.8) | 3 (1.9) | ||
Antihistamines, n (%) | 126 (57.0) | 28 (47.5) | 98 (60.5) | 0.08 | |
Antipyretics, n (%) | 175 (79.2) | 37 (62.7) | 138 (85.2) | 0.0003 | |
Intravenous fluids, n (%) | 189 (85.5) | 45 (76.3) | 144 (88.9) | 0.01 | |
Mannitol, n (%) | 8 (3.6) | 3 (5.1) | 5 (3.1) | 0.48 | |
Steroid, n (%) | 10 (4.5) | 3 (5.1) | 7 (4.3) | 0.80 |
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Pietrzak, M.; Pokorska-Śpiewak, M. Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study. Pediatr. Rep. 2024, 16, 451-460. https://doi.org/10.3390/pediatric16020039
Pietrzak M, Pokorska-Śpiewak M. Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study. Pediatric Reports. 2024; 16(2):451-460. https://doi.org/10.3390/pediatric16020039
Chicago/Turabian StylePietrzak, Maja, and Maria Pokorska-Śpiewak. 2024. "Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study" Pediatric Reports 16, no. 2: 451-460. https://doi.org/10.3390/pediatric16020039
APA StylePietrzak, M., & Pokorska-Śpiewak, M. (2024). Impact of COVID-19 Pandemic on the Clinical Course and Complications of Varicella—A Retrospective Cohort Study. Pediatric Reports, 16(2), 451-460. https://doi.org/10.3390/pediatric16020039