Skip to main content
SpringerLink
Log in

The long-term boomerang effect of COVID-19 on admissions for non-COVID diseases: the ECIEN-2022 study

  • RESEARCH
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Since COVID-19 pandemic started, many changes have been seen in the cycling patterns of pediatric pathologies. On year 2020, we described the initial effects of COVID-19, with a significant decrease in emergency visits and admissions, but 2 years later the situation seems to be reversed. Our study bridges a literature gap by exploring the lasting effects of COVID-19 on pediatric non-COVID admissions, particularly the resurgence of respiratory illnesses. ECIEN-2022 is a single-center, retrospective, observational-study conducted 3 years after the pandemic onset, to describe the long-term effects of COVID-19 in pediatric admissions for non-COVID diseases. Admissions during year 2022 were compared with the Pre-Pandemic Period (PPP: 2015–2019). Pediatric Emergency Department (P-ED) visits, hospital, and Intensive Care Unit (P-ICU) admissions were compared across pre- and post-pandemic periods. Monthly distribution and year-waves are presented. P-ED monthly visits (mean and Standard deviation (SD) raised from 3521 (533) in the PPP to 3775 (996) in 2022 (p < 0.001). Monthly hospital admissions in the 3rd quarter of the Pre-Pandemic Period were 111.7/month (SD:29), dropped to 88.5(SD:6.5) in 2020 and raised to 149(SD:38.8) in 2022 (p = 0.036). An increase in respiratory illnesses was observed in 2022 compared to PPP; Bronchiolitis increased 38%, bronchitis 56%, and admissions for Respiratory Syncytial Virus 67%.

  Conclusion: COVID-19 pandemic has had a significant impact on the use and nature of pediatric health services. The initial decrease has been followed by a boomerang effect with an increase of cases, mainly due to an increase in respiratory infections when pandemic control measures and social restrictions have been lifted. It is essential to maintain an active surveillance and monitorization of these patterns to ensure appropriate healthcare access and utilization.

What is Known:

• COVID-19 pandemic initially led to a significant decrease in emergency visits and admissions for non-COVID diseases.

What is New:

• ECIEN-2022 study investigated the long-term effects of COVID-19 on pediatric admissions for non-COVID diseases, detecting a “boomerang effect” with an increase in pediatric admissions for non-COVID diseases in year 2022.

• Pediatric Emergency Department visits and hospital admissions for non-COVID diseases, especially those due to respiratory infections, increased significantly in 2022 when compared to the Pre-Pandemic Period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

The HUN Hospital datasets analyzed during the current study are not publicly available due to hospital rules, regarding patient information, but are available from the corresponding author on reasonable request.

References

  1. Nobari H, Fashi M, Eskandari A, Villafaina S, Murillo-Garcia Á, Pérez-Gómez J et al (2021) Adolescents and children: a systematic review. Int J Environ Res Public Health 18:4563. Available from https://doi.org/10.3390/ijerph

  2. Runacres A, Mackintosh KA, Knight RL, Sheeran L, Thatcher R, Shelley J et al (2021) Impact of the covid-19 pandemic on sedentary time and behaviour in children and adults: a systematic review and meta-analysis. Vol. 18, International Journal of Environmental Research and Public Health. MDP

  3. Zeng N, Zhao YM, Yan W, Li C, Lu QD, Liu L et al (2023) A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: call for research priority and action. Vol. 28, Molecular Psychiatry. Springer Nat p. 423–33

  4. Bastain TM, Knapp EA, Law A, Algermissen M, Avalos LA, Birnhak Z et al (2022) COVID-19 pandemic experiences and symptoms of pandemic-associated traumatic stress among mothers in the US. JAMA Netw Open 5(12):E2247330

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bayham J, Fenichel EP (2020) Impact of school closures for COVID-19 on the US health-care workforce and net mortality: a modelling study. Lancet Public Health 5(5):e271–e278

    Article  PubMed  PubMed Central  Google Scholar 

  6. Medrano M, Cadenas-Sanchez C, Oses M, Arenaza L, Amasene M, Labayen I (2021) Changes in lifestyle behaviours during the COVID-19 confinement in Spanish children: a longitudinal analysis from the MUGI project. Pediatr Obes 16(4)

  7. Risso FM, Cozzi G, Volonnino M, Cossovel F, Ullmann N, Ciofi degli Atti ML et al (2022) Social distancing during the COVID-19 pandemic resulted in a marked decrease in hospitalisations for bronchiolitis. Acta Paediatrica, Int J Paediatr 111(1):163–4

  8. Pines JM, Zocchi MS, Black BS, Carlson JN, Celedon P, Moghtaderi A et al (2021) Characterizing pediatric emergency department visits during the COVID-19 pandemic. Am J Emerg Med 1(41):201–204

    Article  Google Scholar 

  9. Ramos-Lacuey B, Herranz Aguirre M, Calderón Gallego C, Ilundain López de Munain A, Gembero Esarte E, Moreno-Galarraga L (2021) ECIEN-2020 study: the effect of COVID-19 on admissions for non-COVID-19 diseases. World J Pediatr 17(1):85–91

  10. Radhakrishnan L, Carey K, Hartnett KP, Kite-Powell A, Zwald M, Anderson KN et al (2022) Pediatric emergency department visits before and during the COVID-19 pandemic — United States, January 2019–January 2022. MMWR Morb Mortal Wkly Rep 71(8):313–8. [cited 2023 Feb 25]. Available from https://www.cdc.gov/mmwr/volumes/71/wr/mm7108e1.htm

  11. Huang QS, Wood T, Jelley L, Jennings T, Jefferies S, Daniells K et al (2021) Impact of the COVID-19 nonpharmaceutical interventions on influenza and other respiratory viral infections in New Zealand. Nat Commun 12(1)

  12. Raucci U, Musolino AM, di Lallo D, Piga S, Barbieri MA, Pisani M et al (2021) Impact of the COVID-19 pandemic on the emergency department of a tertiary children’s hospital. Ital J Pediatr 47(1)

  13. Turco R, Russo M, Lenta S, Apicella A, Gagliardo T, Savoia F et al (2023) Pediatric emergency care admissions for somatic symptom disorders during the COVID-19 pandemic. Eur J Pediatr 182(2):957–964

    Article  CAS  PubMed  Google Scholar 

  14. Kersten JM, van Veen M, van Houten MA, Wieringa J, Noordzij JG, Bekhof J et al (2023) Adverse effect of lockdowns during the COVID-19 pandemic: increased incidence of pediatric crisis admissions due to eating disorders and adolescent intoxications. Eur J Pediatr

  15. Chow EJ, Uyeki TM, Chu HY (2022) The effects of the COVID-19 pandemic on community respiratory virus activity. Nature Reviews Microbiology. Nat Res

  16. Garg I, Shekhar R, Sheikh AB, Pal S (2022) Impact of COVID-19 on the changing patterns of respiratory syncytial virus infections. Vol. 14, Infectious Disease Reports. MDPI 558–68

  17. Esteban-Molina A, Royo-Álvarez M, Araujo-Aguilar P, Bernal-Matilla CI (2021) Changes in the incidence and clinical manifestations of paediatric respiratory infections of viral aetiology during the SARS-CoV-2 pandemic. Enferm Infecc Microbiol Clin

  18. Bermúdez Barrezueta L, Matías Del Pozo V, López-Casillas P, Brezmes Raposo M, Gutiérrez Zamorano M, Pino Vázquez M de la A (2022) Variation in the seasonality of the respiratory syncytial virus during the COVID-19 pandemic. Infection 50(4):1001–5

  19. Loconsole D, Centrone F, Rizzo C, Caselli D, Orlandi A, Cardinale F et al (2022) Out-of-season epidemic of respiratory syncytial virus during the COVID-19 pandemic: the high burden of child hospitalization in an academic hospital in Southern Italy in 2021. Children 9(6)

  20. Carlone G, Graziano G, Trotta D, Cafagno C, Aricò MO, Campodipietro G et al (2023) Bronchiolitis 2021–2022 epidemic: multicentric analysis of the characteristics and treatment approach in 214 children from different areas in Italy. Eur J Pediatr

  21. Bermúdez Barrezueta L, Gutiérrez Zamorano M, López-Casillas P, Brezmes-Raposo M, Sanz Fernández I, Pino Vázquez M de la A (2022) Influence of the COVID-19 pandemic on the epidemiology of acute bronchiolitis. Enferm Infecc Microbiol Clin

  22. Nygaard U, Hartling UB, Nielsen J, Vestergaard LS, Dungu KHS, Nielsen JSA et al (2023) Hospital admissions and need for mechanical ventilation in children with respiratory syncytial virus before and during the COVID-19 pandemic: a Danish nationwide cohort study. Lancet Child Adolesc Health

  23. Fourgeaud J, Toubiana J, Chappuy H, Delacourt C, Moulin F, Parize P et al (2021) Impact of public health measures on the post-COVID-19 respiratory syncytial virus epidemics in France. Eur J Clin Microbiol Infect Dis 40(11):2389–2395

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Mohebi L, Karami H, Mirsalehi N, Ardestani NH, Yavarian J, Mard-Soltani M et al (2022) A delayed resurgence of respiratory syncytial virus (RSV) during the COVID-19 pandemic: an unpredictable outbreak in a small proportion of children in the Southwest of Iran, April 2022. J Med Virol 94(12):5802–5807

    Article  CAS  PubMed  Google Scholar 

  25. Park JY, Kim H Il, Kim JH, Park S, Hwang Y Il, Jang SH et al (2021) Changes in respiratory virus infection trends during the covid-19 pandemic in South Korea: the effectiveness of public health measures. Korean J Int Med 36(5):1157–68

  26. Gemma L. Saravanos, Nan Hu, Nursrat Homaira, David J (2020) Muscatello, Adam Jaffe, Adam W. Bartlett, et al. RSV Epidemiology in Australia before and during COVID-19. Pediatrics 146(4)

  27. van Summeren J, Meijer A, Aspelund G, Casalegno JS, Erna G, Hoang U et al (2021) Low levels of respiratory syncytial virus activity in Europe during the 2020/21 season: what can we expect in the coming summer and autumn/winter? Eurosurveillance 26(29). Available from https://www.eurosurveillance.org/content/. https://doi.org/10.2807/1560-7917.ES.2021.26.29.2100639

  28. Viguria N, Martínez-Baz I, Moreno-Galarraga L, Sierrasesúmaga L, Salcedo B, Castilla J (2018) Respiratory syncytial virus hospitalization in children in northern Spain. PLoS One 13(11)

Download references

Funding

No funding was secured for this study. No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject. Dr Moreno-Galarraga was partially supported by Fundación Ramón Areces (Scholarships for Postdoctoral Studies XXXIV) research grant for foreign centers.

Author information

Authors and Affiliations

  1. Department of Pediatrics, HUN, Hospital Universitario de Navarra, Pamplona, Navarra, Spain

    Beatriz Ramos La Cuey, Neus Saloni-Gomez, Andrea Ilundain López de Munain, Mercedes Herranz Aguirre & Ainhoa Iceta

  2. Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarra, Spain

    Alejandro Fernández-Montero

  3. IdiSNA, Navarra Institute for Health Research, Pamplona, Navarra, Spain

    Alejandro Fernández-Montero, Natividad Viguria, Leyre López Fernández & Laura Moreno-Galarraga

  4. Pediatric Pulmonology, HUN, Hospital Universitario de Navarra, C/ Irunlarrea No 8, 31008, Pamplona, Navarra, IdisNa, Spain

    Natividad Viguria, Leyre López Fernández & Laura Moreno-Galarraga

Authors
  1. Beatriz Ramos La Cuey
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Neus Saloni-Gomez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Ilundain López de Munain
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alejandro Fernández-Montero
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Natividad Viguria
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Leyre López Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mercedes Herranz Aguirre
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ainhoa Iceta
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Laura Moreno-Galarraga
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BR, NS-G, AIL, NV and LL-F contributed to conception and design, analysis, and draft of the manuscript. AF-M contributed to design, analysis, and revision of the manuscript. BR, MH-A and AI contributed to acquisition and critical revision of the manuscript. LMG contributed to conception and design, acquisition, and critical revision of the final manuscript. All authors have agreed to submit this article in the present form. Each has participated sufficiently in the conception and design of the work. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Laura Moreno-Galarraga.

Ethics declarations

Ethics approval

The local ethics committee approved on May 2020 the study “Comite de Etica del Complejo Hospitalario de Navarra” (CHN: PI_2020/38: Estudio epidemiológico de las infecciones respiratorias por el nuevo Coronavirus SARS-CoV-2 en población pediátrica).

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Gregorio Milani

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ramos La Cuey, B., Saloni-Gomez, N., Ilundain López de Munain, A. et al. The long-term boomerang effect of COVID-19 on admissions for non-COVID diseases: the ECIEN-2022 study. Eur J Pediatr 182, 4227–4236 (2023). https://doi.org/10.1007/s00431-023-05101-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-023-05101-1

Keywords

Search

Navigation