TY - JOUR
T1 - The Recent Increase in Invasive Bacterial Infections A Report From the National COVID Cohort Collaborative
AU - the N3C consortium
AU - Martin, Blake
AU - DeWitt, Peter E.
AU - Russell, Seth
AU - Haendel, Melissa
AU - Sanchez-Pinto, Nelson
AU - Albers, David J.
AU - Jhaveri, Ravi R.
AU - Moffitt, Richard
AU - Bennett, Tellen D.
AU - Wilcox, Adam B.
AU - Lee, Adam M.
AU - Graves, Alexis
AU - Anzalone, Alfred
AU - Manna, Amin
AU - Saha, Amit
AU - Olex, Amy
AU - Zhou, Andrea
AU - Williams, Andrew E.
AU - Southerland, Andrew
AU - Girvin, Andrew T.
AU - Walden, Anita
AU - Sharathkumar, Anjali A.
AU - Amor, Benjamin
AU - Bates, Benjamin
AU - Hendricks, Brian
AU - Patel, Brijesh
AU - Alexander, Caleb
AU - Bramante, Carolyn
AU - Ward-Caviness, Cavin
AU - Madlock-Brown, Charisse
AU - Suver, Christine
AU - Chute, Christopher
AU - Dillon, Christopher
AU - Wu, Chunlei
AU - Schmitt, Clare
AU - Takemoto, Cliff
AU - Housman, Dan
AU - Gabriel, Davera
AU - Eichmann, David A.
AU - Mazzotti, Diego
AU - Brown, Don
AU - Boudreau, Eilis
AU - Hill, Elaine
AU - Zampino, Elizabeth
AU - Marti, Emily Carlson
AU - Pfaff, Emily R.
AU - French, Evan
AU - Koraishy, Farrukh M.
AU - Mariona, Federico
AU - Subbian, Vignesh
N1 - Publisher Copyright:
Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2025/3/1
Y1 - 2025/3/1
N2 - Background: When coronavirus disease 2019 (COVID-19) mitigation efforts waned, viral respiratory infections (VRIs) surged, potentially increasing the risk of postviral invasive bacterial infections (IBIs). We sought to evaluate the change in epidemiology and relationships between specific VRIs and IBIs [complicated pneumonia, complicated sinusitis and invasive group A streptococcus (iGAS)] over time using the National COVID Cohort Collaborative (N3C) dataset. Methods: We performed a secondary analysis of all prospectively collected pediatric (<19 years old) and adult encounters at 58 N3C institutions, stratified by era: pre-pandemic (January 1, 2018, to February 28, 2020) versus pandemic (March 1, 2020, to June 1, 2023). We compared the characteristics and outcomes of patients with prespecified VRIs and IBIs, including correlation between VRI cases and subsequent IBI cases. Results: We identified 965,777 pediatric and 9,336,737 adult hospitalizations. Compared with pre-pandemic, pandemic-era children demonstrated higher mean monthly cases of adenovirus (121 vs. 79.1), iGAS (5.8 vs. 3.3), complicated pneumonia (282 vs. 178) and complicated sinusitis (29.8 vs. 16.3), P < 0.005 for all. Among pandemic-era children, peak correlation between RSV cases and subsequent complicated sinusitis cases occurred with a 60-day lag (correlation coefficient 0.56, 95% confidence interval: 0.52–0.59, P < 0.001) while peak correlation between influenza and complicated sinusitis occurred with a 33-day lag (0.55, 0.51–0.58, P < 0.001). Correlation among other VRI–IBI pairs was modest during the pandemic and often lower than during the pre-pandemic era. Conclusions: Since COVID-19 emerged, mean monthly cases of iGAS, complicatedpneumonia,andcomplicatedsinusitishavebeenhigher.Pandemic-era RSV and influenza cases were correlated with subsequent cases of complicated sinusitis in children. However, many other VRI–IBI correlations decreased during the pandemic.
AB - Background: When coronavirus disease 2019 (COVID-19) mitigation efforts waned, viral respiratory infections (VRIs) surged, potentially increasing the risk of postviral invasive bacterial infections (IBIs). We sought to evaluate the change in epidemiology and relationships between specific VRIs and IBIs [complicated pneumonia, complicated sinusitis and invasive group A streptococcus (iGAS)] over time using the National COVID Cohort Collaborative (N3C) dataset. Methods: We performed a secondary analysis of all prospectively collected pediatric (<19 years old) and adult encounters at 58 N3C institutions, stratified by era: pre-pandemic (January 1, 2018, to February 28, 2020) versus pandemic (March 1, 2020, to June 1, 2023). We compared the characteristics and outcomes of patients with prespecified VRIs and IBIs, including correlation between VRI cases and subsequent IBI cases. Results: We identified 965,777 pediatric and 9,336,737 adult hospitalizations. Compared with pre-pandemic, pandemic-era children demonstrated higher mean monthly cases of adenovirus (121 vs. 79.1), iGAS (5.8 vs. 3.3), complicated pneumonia (282 vs. 178) and complicated sinusitis (29.8 vs. 16.3), P < 0.005 for all. Among pandemic-era children, peak correlation between RSV cases and subsequent complicated sinusitis cases occurred with a 60-day lag (correlation coefficient 0.56, 95% confidence interval: 0.52–0.59, P < 0.001) while peak correlation between influenza and complicated sinusitis occurred with a 33-day lag (0.55, 0.51–0.58, P < 0.001). Correlation among other VRI–IBI pairs was modest during the pandemic and often lower than during the pre-pandemic era. Conclusions: Since COVID-19 emerged, mean monthly cases of iGAS, complicatedpneumonia,andcomplicatedsinusitishavebeenhigher.Pandemic-era RSV and influenza cases were correlated with subsequent cases of complicated sinusitis in children. However, many other VRI–IBI correlations decreased during the pandemic.
KW - COVID-19
KW - invasive bacterial infection
KW - post-viral
UR - http://www.scopus.com/inward/record.url?scp=85207344796&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85207344796&partnerID=8YFLogxK
U2 - 10.1097/INF.0000000000004575
DO - 10.1097/INF.0000000000004575
M3 - Article
C2 - 39736073
AN - SCOPUS:85207344796
SN - 0891-3668
VL - 44
SP - 217
EP - 227
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 3
ER -