TY - JOUR
T1 - Mycoplasma pneumoniae incidence, phenotype, and severity in children and adolescents in Denmark before, during, and after the COVID-19 pandemic
T2 - a nationwide multicentre population-based cohort study
AU - Dungu, Kia H.S.
AU - Holm, Mette
AU - Hartling, Ulla
AU - Jensen, Lise H.
AU - Nielsen, Allan Bybeck
AU - Schmidt, Lisbeth S.
AU - Toustrup, Lise B.
AU - Hansen, Lotte H.
AU - Dahl, Kathrin W.
AU - Matthesen, Kirstine T.
AU - Nordholm, Anne C.
AU - Uldum, Søren
AU - Emborg, Hanne Dorthe
AU - Rytter, Maren J.H.
AU - Nygaard, Ulrikka
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - Corticosteroids
KW - COVID-19
KW - MIRM
KW - Mycoplasma
KW - Mycoplasma induced rash and mucositis
KW - Mycoplasma pneumoniae
KW - Mycositis
KW - Reactive infectious mucocutaneous eruptions
KW - Resurgence
KW - RIME
U2 - 10.1016/j.lanepe.2024.101103
DO - 10.1016/j.lanepe.2024.101103
M3 - Journal article
AN - SCOPUS:85206433309
SN - 2666-7762
VL - 47
JO - The Lancet Regional Health - Europe
JF - The Lancet Regional Health - Europe
M1 - 101103
ER -