<i>Mycoplasma pneumoniae</i> 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.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 39469091.
- Also identified by DOI 10.1016/j.lanepe.2024.101103 and PMC identifier 11513821.
- Licence recorded as CC BY-NC.
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Abstract
<i>Mycoplasma pneumoniae</i> infections resurged globally in 2023-2024 after a three-year decline during the COVID-19 pandemic. We explored the incidence and severity of <i>M pneumoniae</i> infections in children and adolescents before, during, and after the pandemic. This nationwide, population-based cohort study included all Danish children and adolescents aged 0-17 years with a positive <i>M pneumoniae</i> 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. Among the Danish population of 1,152,000 children and adolescents, 14,241 with a positive PCR test for <i>M pneumoniae</i> 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). <i>M pneumoniae</i>-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). In Denmark, <i>M pneumoniae</i> 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 <i>M pneumoniae</i> during the COVID-19 pandemic. While the severity of <i>M pneumoniae</i> infections did not change in 2023-2024, the five-fold increase in <i>M pneumoniae</i>-induced rash and mucositis in children and adolescents highlights <i>M pneumoniae</i> as an important pathogen causing mucocutaneous eruptions. Innovation Fund Denmark and Rigshospitalets Forskningsfond.