Impacto da flexibilização das medicas não farmacológicas para Covid-19 nas internações hospitalares por doenças respiratórias em crianças : estudo populacional nacional

Abstract

Background: Lower respiratory tract diseases (LRTD) are among the most common causes of pediatric mortality worldwide, pneumonia being the leading one. In 2020, with the Coronavirus Disease 2019 (COVID-19) pandemic, non-pharmacological interventions (NPI) were implemented to contain the spread of the disease. These NPI showed impact in hospitalizations and deaths due to respiratory diseases in children, but the impact after the relaxation of these measures have not yet been analyzed. The aim of this study is to analyze the impact of the easing of NPI on the incidence of hospitalizations and mortality due to pneumonia, acute bronchiolitis and asthma in children in Brazil. Methods: This is an ecological study based on data collection from the Brazil’s Department of Informatics of the Unified Health System (DATASUS). Information was collected about hospitalization, deaths and hospitalization costs due to communityacquired pneumonia, acute bronchiolitis and asthma in children and adolescents aged 0 to 19 years in Brazil, from 2019 to 2021. To obtain the relative risk and the confidence interval, Poisson regression was used and, for statistical significance, p<0.05 was used. Results: From 2019 to 2021, there were 3,546 deaths and 632,981 hospitalizations due to pneumonia, acute bronchiolitis and asthma in children in Brazil. Even after these measures were relaxed, there was a significant reduction in hospitalizations due to pneumonia (58%), bronchiolitis (33%) and asthma (26%), as well as reductions of 46%, 51% and 48% in deaths due to these diseases, respectively. The costs of hospitalizations due to these diseases were also lower in 2021 compared to 2019, with a 52% drop in costs for hospitalizations due to pneumonia. Conclusion: The present study showed that, even after easing of NPI to contain COVID-19, there was a reduction in hospitalizations and deaths due to pneumonia, acute bronchiolitis and asthma in children in Brazil. A reduction in hospitalization costs related to these diseases was also observed. These findings reinforce the impact of NPI implementation on child health and public health resources.