J Korean Med Sci.  2023 Oct;38(40):e311. 10.3346/jkms.2023.38.e311.

Impact of Nonpharmacological Interventions on Severe Acute Respiratory Infections in Children: From

• Yoon Y
• Lee HS
• Yang J
• Gwack J
• Kim BI
• Cha Jo
• Min KH
• Kim YK
• Shim JJ
• Lee YS

• KMID: 2546930
• DOI: http://doi.org/10.3346/jkms.2023.38.e311

Abstract

Background
Nonpharmacological interventions (NPIs) reduce the incidence of respiratory infections. After NPIs imposed during the coronavirus disease 2019 pandemic ceased, respiratory infections gradually increased worldwide. However, few studies have been conducted on severe respiratory infections requiring hospitalization in pediatric patients. This study compares epidemiological changes in severe respiratory infections during pre-NPI, NPI, and post-NPI periods in order to evaluate the effect of that NPI on severe respiratory infections in children.
Methods
We retrospectively studied data collected at 13 Korean sentinel sites from January 2018 to October 2022 that were lodged in the national Severe Acute Respiratory Infections (SARIs) surveillance database.
Results
A total of 9,631 pediatric patients were admitted with SARIs during the pre-NPI period, 579 during the NPI period, and 1,580 during the post-NPI period. During the NPI period, the number of pediatric patients hospitalized with severe respiratory infections decreased dramatically, thus from 72.1 per 1,000 to 6.6 per 1,000. However, after NPIs ceased, the number increased to 22.8 per 1,000. During the post-NPI period, the positive test rate increased to the level noted before the pandemic.
Conclusion
Strict NPIs including school and daycare center closures effectively reduced severe respiratory infections requiring hospitalization of children. However, childcare was severely compromised. To prepare for future respiratory infections, there is a need to develop a social consensus on NPIs that are appropriate for children.

Keyword

SARS-CoV-2; Viruses; Schools; Child; Republic of Korea

Figure

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  Fig. 1 Flow chart of enrolled patients.NPI = nonpharmacological intervention, SARI = Severe Acute Respiratory Infection.

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  Fig. 2 Epidemic proportion curves (95% confidence intervals) for severe acute respiratory virus infection relative to total hospitalization in the pre-NPI period, NPI period, and post-NPI period.NPI = nonpharmacological intervention.

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  Fig. 3 Epidemic proportion curves (95% confidence intervals) for each respiratory virus infection relative to total hospitalization in the pre-NPI period, NPI period, and post-NPI period. (A) Adenovirus. (B) Rhinovirus. (C) Influenza virus. (D) Parainfluenza virus. (E) Bocavirus. (F) Metapneumovirus. (G) Respiratory syncytial virus. (H) Human coronavirus.NPI = nonpharmacological intervention.

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