Kia H.S. Dungu , Mette Holm , Ulla Hartling , Lise H. Jensen , Allan Bybeck Nielsen , Lisbeth S. Schmidt , Lise B. Toustrup , Lotte H. Hansen , Kathrin W. Dahl , Kirstine T. Matthesen , Anne C. Nordholm , Søren Uldum , Hanne-Dorthe Emborg , Maren J.H. Rytter , Ulrikka Nygaard
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We obtained clinical details for patients hospitalised for 24 h or more. Risk ratios for infections, hospitalisations, and disease manifestations in 2023–2024 versus pre-COVID-19 seasons were calculated using Fisher’s exact and Pearson’s χ<sup>2</sup> tests. A season was defined from May 1 to April 30.</div></div><div><h3>Findings</h3><div>Among the Danish population of 1,152,000 children and adolescents, 14,241 with a positive PCR test for <em>M pneumoniae</em> were included. In 2023–2024, children and adolescents with a positive PCR rose 2.9-fold (95% CI 2.8–3.1; p < 0.0001) compared to the pre-COVID-19 seasons, and hospitalisations rose 2.6-fold (95% CI 2.0–3.3; p < 0.0001). <em>M pneumoniae</em>-induced rash and mucositis increased 5.3-fold (95% CI 1.8–15.3; p = 0.0007). In 2023–2024 compared to the pre-COVID-19 seasons, there was no difference in the proportion of hospitalisation (360 [4%] of 8165 versus 230 [4%] of 6009; p = 0.09), the median duration of hospital stay (3 days [IQR 2–5] versus 3 days [IQR 2–5]; p = 0.84), or paediatric intensive care unit admission (14 [4%] of 360 versus 9 [4%] of 230 p = 1.00).</div></div><div><h3>Interpretation</h3><div>In Denmark, <em>M pneumoniae</em> infections and hospitalisations increased three-fold in 2023–2024 compared with the pre-COVID-19 seasons, indicating an immunity debt caused by the decline in <em>M pneumoniae</em> during the COVID-19 pandemic. While the severity of <em>M pneumoniae</em> infections did not change in 2023–2024, the five-fold increase in <em>M pneumoniae</em>-induced rash and mucositis in children and adolescents highlights <em>M pneumoniae</em> as an important pathogen causing mucocutaneous eruptions.</div></div><div><h3>Funding</h3><div><span>Innovation Fund Denmark</span> and <span>Rigshospitalets Forskningsfond</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"47 ","pages":"Article 101103"},"PeriodicalIF":13.6000,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mycoplasma pneumoniae incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic: a nationwide multicentre population-based cohort study\",\"authors\":\"Kia H.S. Dungu , Mette Holm , Ulla Hartling , Lise H. Jensen , Allan Bybeck Nielsen , Lisbeth S. Schmidt , Lise B. Toustrup , Lotte H. Hansen , Kathrin W. Dahl , Kirstine T. Matthesen , Anne C. Nordholm , Søren Uldum , Hanne-Dorthe Emborg , Maren J.H. Rytter , Ulrikka Nygaard\",\"doi\":\"10.1016/j.lanepe.2024.101103\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div><em>Mycoplasma pneumoniae</em> infections resurged globally in 2023–2024 after a three-year decline during the COVID-19 pandemic. We explored the incidence and severity of <em>M pneumoniae</em> infections in children and adolescents before, during, and after the pandemic.</div></div><div><h3>Methods</h3><div>This nationwide, population-based cohort study included all Danish children and adolescents aged 0–17 years with a positive <em>M pneumoniae</em> PCR test from May 1, 2016, to April 30, 2024. We obtained clinical details for patients hospitalised for 24 h or more. Risk ratios for infections, hospitalisations, and disease manifestations in 2023–2024 versus pre-COVID-19 seasons were calculated using Fisher’s exact and Pearson’s χ<sup>2</sup> tests. A season was defined from May 1 to April 30.</div></div><div><h3>Findings</h3><div>Among the Danish population of 1,152,000 children and adolescents, 14,241 with a positive PCR test for <em>M pneumoniae</em> were included. In 2023–2024, children and adolescents with a positive PCR rose 2.9-fold (95% CI 2.8–3.1; p < 0.0001) compared to the pre-COVID-19 seasons, and hospitalisations rose 2.6-fold (95% CI 2.0–3.3; p < 0.0001). <em>M pneumoniae</em>-induced rash and mucositis increased 5.3-fold (95% CI 1.8–15.3; p = 0.0007). In 2023–2024 compared to the pre-COVID-19 seasons, there was no difference in the proportion of hospitalisation (360 [4%] of 8165 versus 230 [4%] of 6009; p = 0.09), the median duration of hospital stay (3 days [IQR 2–5] versus 3 days [IQR 2–5]; p = 0.84), or paediatric intensive care unit admission (14 [4%] of 360 versus 9 [4%] of 230 p = 1.00).</div></div><div><h3>Interpretation</h3><div>In Denmark, <em>M pneumoniae</em> infections and hospitalisations increased three-fold in 2023–2024 compared with the pre-COVID-19 seasons, indicating an immunity debt caused by the decline in <em>M pneumoniae</em> during the COVID-19 pandemic. While the severity of <em>M pneumoniae</em> infections did not change in 2023–2024, the five-fold increase in <em>M pneumoniae</em>-induced rash and mucositis in children and adolescents highlights <em>M pneumoniae</em> as an important pathogen causing mucocutaneous eruptions.</div></div><div><h3>Funding</h3><div><span>Innovation Fund Denmark</span> and <span>Rigshospitalets Forskningsfond</span>.</div></div>\",\"PeriodicalId\":53223,\"journal\":{\"name\":\"Lancet Regional Health-Europe\",\"volume\":\"47 \",\"pages\":\"Article 101103\"},\"PeriodicalIF\":13.6000,\"publicationDate\":\"2024-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lancet Regional Health-Europe\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666776224002709\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Europe","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666776224002709","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Mycoplasma pneumoniae incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic: a nationwide multicentre population-based cohort study
Background
Mycoplasma pneumoniae infections resurged globally in 2023–2024 after a three-year decline during the COVID-19 pandemic. We explored the incidence and severity of M pneumoniae infections in children and adolescents before, during, and after the pandemic.
Methods
This nationwide, population-based cohort study included all Danish children and adolescents aged 0–17 years with a positive M pneumoniae PCR test from May 1, 2016, to April 30, 2024. We obtained clinical details for patients hospitalised for 24 h or more. Risk ratios for infections, hospitalisations, and disease manifestations in 2023–2024 versus pre-COVID-19 seasons were calculated using Fisher’s exact and Pearson’s χ2 tests. A season was defined from May 1 to April 30.
Findings
Among the Danish population of 1,152,000 children and adolescents, 14,241 with a positive PCR test for M pneumoniae were included. In 2023–2024, children and adolescents with a positive PCR rose 2.9-fold (95% CI 2.8–3.1; p < 0.0001) compared to the pre-COVID-19 seasons, and hospitalisations rose 2.6-fold (95% CI 2.0–3.3; p < 0.0001). M pneumoniae-induced rash and mucositis increased 5.3-fold (95% CI 1.8–15.3; p = 0.0007). In 2023–2024 compared to the pre-COVID-19 seasons, there was no difference in the proportion of hospitalisation (360 [4%] of 8165 versus 230 [4%] of 6009; p = 0.09), the median duration of hospital stay (3 days [IQR 2–5] versus 3 days [IQR 2–5]; p = 0.84), or paediatric intensive care unit admission (14 [4%] of 360 versus 9 [4%] of 230 p = 1.00).
Interpretation
In Denmark, M pneumoniae infections and hospitalisations increased three-fold in 2023–2024 compared with the pre-COVID-19 seasons, indicating an immunity debt caused by the decline in M pneumoniae during the COVID-19 pandemic. While the severity of M pneumoniae infections did not change in 2023–2024, the five-fold increase in M pneumoniae-induced rash and mucositis in children and adolescents highlights M pneumoniae as an important pathogen causing mucocutaneous eruptions.
Funding
Innovation Fund Denmark and Rigshospitalets Forskningsfond.
期刊介绍：
The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.
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