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Article: Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study
Title | Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study |
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Authors | |
Keywords | COVID-19 epidemiology public health respiratory infections thoracic medicine |
Issue Date | 2021 |
Publisher | BMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com |
Citation | BMJ Open, 2021, v. 11 n. 10, p. article no. e055575 How to Cite? |
Abstract | Objectives: To compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years.
Design: Retrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015–December 2019 and March 2020–March 2021. January–February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic.
Setting: Episode-based data by retrieval of hospitalisation records from the Hospital Authority’s territory-wide electronic medical record database in Hong Kong.
Participants: Hospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours.
Primary and secondary outcomes: Primary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality.
Results: Monthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015–December 2019 to March 2020–March 2021 were −70% (95% CI −87% to −35%, p=0.0025), –43% (95% CI −59% to −19%, p=0.0014) and −11% (95% CI −13% to −10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed.
Conclusions: Incidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria. |
Persistent Identifier | http://hdl.handle.net/10722/307681 |
ISSN | 2023 Impact Factor: 2.4 2023 SCImago Journal Rankings: 0.971 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan, KPF | - |
dc.contributor.author | Ma, TF | - |
dc.contributor.author | Ip, MSM | - |
dc.contributor.author | Ho, PL | - |
dc.date.accessioned | 2021-11-12T13:36:15Z | - |
dc.date.available | 2021-11-12T13:36:15Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | BMJ Open, 2021, v. 11 n. 10, p. article no. e055575 | - |
dc.identifier.issn | 2044-6055 | - |
dc.identifier.uri | http://hdl.handle.net/10722/307681 | - |
dc.description.abstract | Objectives: To compare the incidence and severity of invasive pneumococcal diseases (IPDs), pneumococcal pneumonia and all-cause pneumonia during the COVID-19 pandemic period with universal masking and social distancing with that of previous 5 years. Design: Retrospective observational study on incidence of IPDs, pneumococcal pneumonia and all-cause pneumonia between January 2015–December 2019 and March 2020–March 2021. January–February 2020 was excluded from analysis as it was treated as a transitional period between normal time and pandemic. Setting: Episode-based data by retrieval of hospitalisation records from the Hospital Authority’s territory-wide electronic medical record database in Hong Kong. Participants: Hospitalised patients with IPD (n=742), pneumococcal pneumonia (n=2163) and all-cause pneumonia (including COVID-19 pneumonia, n=453 999) aged 18 years or above. Control diagnoses were included to assess confounding from health-seeking behaviours. Primary and secondary outcomes: Primary outcome is the incidence of diseases between two periods. Secondary outcomes include disease severity surrogated by length of stay and mortality. Results: Monthly average number of IPD, pneumococcal pneumonia and all-cause pneumonia hospitalisation significantly decreased by 88.9% (95% CI 79.8% to 98.0%, p<0.0005), 72.5% (95% CI 65.9% to 79.1%, p<0.0005) and 17.5% (95% CI 16.8% to 18.2%, p<0.0005), respectively. Changes in trend from January 2015–December 2019 to March 2020–March 2021 were −70% (95% CI −87% to −35%, p=0.0025), –43% (95% CI −59% to −19%, p=0.0014) and −11% (95% CI −13% to −10%, p<0.0005), respectively. Length of stay for IPD and pneumococcal pneumonia episodes were insignificantly different in the two periods. No reductions in hospitalisations for control diagnoses were observed. Conclusions: Incidence of IPD, pneumococcal pneumonia and all-cause pneumonia decreased during the COVID-19 pandemic. This was observed with universal masking and social distancing. We postulated this is related to reduced transmission of respiratory viruses and bacteria. | - |
dc.language | eng | - |
dc.publisher | BMJ Publishing Group: BMJ Open. The Journal's web site is located at http://bmjopen.bmj.com | - |
dc.relation.ispartof | BMJ Open | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | COVID-19 | - |
dc.subject | epidemiology | - |
dc.subject | public health | - |
dc.subject | respiratory infections | - |
dc.subject | thoracic medicine | - |
dc.title | Invasive pneumococcal disease, pneumococcal pneumonia and all-cause pneumonia in Hong Kong during the COVID-19 pandemic compared with the preceding 5 years: a retrospective observational study | - |
dc.type | Article | - |
dc.identifier.email | Ip, MSM: msmip@hku.hk | - |
dc.identifier.email | Ho, PL: plho@hku.hk | - |
dc.identifier.authority | Ip, MSM=rp00347 | - |
dc.identifier.authority | Ho, PL=rp00406 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1136/bmjopen-2021-055575 | - |
dc.identifier.pmid | 34635536 | - |
dc.identifier.pmcid | PMC8506049 | - |
dc.identifier.scopus | eid_2-s2.0-85117088235 | - |
dc.identifier.hkuros | 329803 | - |
dc.identifier.volume | 11 | - |
dc.identifier.issue | 10 | - |
dc.identifier.spage | article no. e055575 | - |
dc.identifier.epage | article no. e055575 | - |
dc.identifier.isi | WOS:000706766500028 | - |
dc.publisher.place | United Kingdom | - |