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Prevalence of Serious Bacterial Infections Among Febrile Infants 90 Days or Younger in a Canadian Urban Pediatric Emergency Department During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Approximately 2% of all full-term neonates are evaluated for fever in the first months of life, and there exists significant ongoing variation in their care.1 Although most febrile neonates and infants 90 days or younger (hereafter referred to as young infants) have self-limited viral illnesses, the prevalence of life-threatening serious bacterial infections (SBIs) has remained approximately 10% for more than 30 years.1 On March 11, 2020, the COVID-19 pandemic was declared, and since that time, studies worldwide have reported a 30% to 89% reduction in the number of children brought to emergency care2,3 as well as fewer circulating respiratory viruses owing to widespread COVID-19 public health mitigation strategies.4,5 To our knowledge, the epidemiologic characteristics of SBIs among febrile young infants during the COVID-19 pandemic has not previously been assessed. We sought to assess the prevalence of SBIs among febrile young infants evaluated in the emergency department (ED) for fever during the COVID-19 pandemic.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: May 6, 2021.

Published: July 13, 2021. doi:10.1001/jamanetworkopen.2021.16919

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Burstein B et al. JAMA Network Open.

Corresponding Author: Brett Burstein, MD, CM, PhD, MPH, Montreal Children’s Hospital, Division of Pediatric Emergency Medicine, McGill University Health Centre, 1001 Decarie Blvd, Montreal, Quebec, H4C 3J1, Canada (brett.burstein@mail.mcgill.ca).

Author Contributions: Dr Burstein and Ms Yannopoulos had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Burstein.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Burstein.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Burstein.

Administrative, technical, or material support: Anderson, Yannopoulos.

Conflict of Interest Disclosures: None reported.

References
1.
Greenhow  TL , Hung  YY , Pantell  RH .  Management and outcomes of previously healthy, full-term, febrile infants ages 7 to 90 days.   Pediatrics. 2016;138(6):e20160270. doi:10.1542/peds.2016-0270 PubMedGoogle Scholar
2.
Goldman  RD , Grafstein  E , Barclay  N , Irvine  MA , Portales-Casamar  E .  Paediatric patients seen in 18 emergency departments during the COVID-19 pandemic.   Emerg Med J. 2020;37(12):773-777. PubMedGoogle Scholar
3.
Kruizinga  MD , Peeters  D , van Veen  M ,  et al.  The impact of lockdown on pediatric ED visits and hospital admissions during the COVID19 pandemic: a multicenter analysis and review of the literature.   Eur J Pediatr. 2021. doi:10.1007/s00431-021-04015-0 PubMedGoogle Scholar
4.
Kuitunen  I , Artama  M , Mäkelä  L , Backman  K , Heiskanen-Kosma  T , Renko  M .  Effect of social distancing due to the COVID-19 pandemic on the incidence of viral respiratory tract infections in children in Finland during early 2020.   Pediatr Infect Dis J. 2020;39(12):e423-e427. doi:10.1097/INF.0000000000002845 PubMedGoogle ScholarCrossref
5.
Yeoh  DK , Foley  DA , Minney-Smith  CA ,  et al.  The impact of COVID-19 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 Australian winter.   Clin Infect Dis. 2020;ciaa1475. doi:10.1093/cid/ciaa1475 PubMedGoogle Scholar
6.
Leibowitz  J , Krief  W , Barone  S ,  et al. Comparison of clinical and epidemiologic characteristics of young febrile infants with and without severe acute respiratory syndrome coronavirus-2 infection.  J Pediatr. 2021;229:41-47. doi:10.1016/j.jpeds.2020.10.002
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