Na Hyejin, Lee Sanghoon, Kim Seo Hee, Kim Young Ok
Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea.
Department of Pediatrics, Chonnam University Children's Hospital, Gwangju, Korea.
Clin Exp Pediatr. 2024 Apr;67(4):213-220. doi: 10.3345/cep.2023.01137. Epub 2024 Mar 19.
Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG.
Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic.
We screened 1134 patients (3-36 months) with "other and unspecified convulsions" treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference.
Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data.
During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.
轻度胃肠炎伴良性惊厥(CwG)在冬季幼儿中很常见。在2019冠状病毒病(COVID-19)大流行初期,病毒性胃肠炎的发病率下降且季节性变化消失,这可能会改变CwG。
在此,我们调查了COVID-19大流行期间CwG的发病率、季节性变化及致病病毒的变化情况。
我们筛选了2017年3月至2023年2月在全南国立大学医院接受治疗的1134例“其他未明确的惊厥”患者(3至36个月);其中,我们纳入了41例(3.6%)CwG患者。我们比较了他们在第一阶段(2017年3月至2020年2月)和第二阶段(2020年3月至2023年2月)的病历。韩国疾病控制与预防机构(KDCA)公开的病毒性胃肠炎监测数据作为参考进行了回顾。
41例CwG患者中,第一阶段有18例(613例中的2.9%),第二阶段有23例(512例中的4.4%)(P = 0.184)。在第一阶段,CwG主要发生在冬季和春季(分别为55.6%和22.2%)。在第二阶段,冬季CwG病例较少(39.1%),夏季和秋季病例较多(分别为26.1%和17.4%):与诺如病毒基因组II(GII)相关的CwG病例在夏季显著增加(38.5%对0%,P = 0.046)。诺如病毒GII是最常见的病毒(分离株的56.1%)。肠道腺病毒是第二常见的病毒(19.5%),第一阶段有1例,第二阶段有7例(P = 0.059)。肠道腺病毒相关CwG的临床特征与诺如病毒相关的相似。CwG的季节性变化和病毒病因与KDCA粪便监测数据中观察到的一致。
在COVID-19大流行期间,CwG发病率没有变化,季节性变化不明显,且肠道腺病毒相关CwG的发病率增加。