{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:33:18Z","timestamp":1779917598168,"version":"3.53.1"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The imposition of lockdowns during the severe acute respiratory syndrome coronavirus\u20102\u00a0pandemic led to a significant decrease in pediatric care utilization in 2020. After restrictions were loosened, a surge in pediatric respiratory disease was observed in pediatric wards. The aim of this study was to quantify the effect of the lockdown(s) on the incidence of pediatric respiratory disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For this multicenter\u00a0retrospective study, emergency department (ED) visit and admission data between January 2017 and September 2021 was collected from eight general hospitals in the Netherlands. Clinical diagnoses were extracted and categorized in groups (\u201ccommunicable infectious disease,\u201d \u201call respiratory infections,\u201d \u201cupper respiratory tract infection,\u201d \u201clower respiratory tract infection,\u201d and \u201casthma\/preschool wheezing\u201d). The incidence of admissions and ED visits during 2020 and 2021 was compared to the incidence in 2017\u20132019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Successive lockdowns resulted in a maximum decrease of 61% and 57% in ED visits and admissions, respectively. After loosening restrictions during the summer of 2021, a 48% overall increase in ED visits and 31% overall increase in admission numbers was observed in July compared to the average July in 2017\u20132019. This was explained by a 381% increase in ED visits and a 528% increase in ward admissions due to overall respiratory infections, mainly due to lower respiratory tract infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Successive lockdowns in the spring and winter of 2020 and 2021 led to a decreased incidence of communicable infections, especially respiratory tract infections. The resulting lack of pediatric immunity resulted in an off\u2010season surge in care utilization at an unexpected moment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.26327","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T15:21:57Z","timestamp":1674660117000},"page":"1229-1236","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Effect of lockdowns on the epidemiology of pediatric respiratory disease\u2014A retrospective analysis of the 2021 summer epidemic"],"prefix":"10.1002","volume":"58","author":[{"given":"Matthijs D.","family":"Kruizinga","sequence":"first","affiliation":[{"name":"Juliana Children's Hospital, Haga Teaching Hospital  Den Haag The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen G.","family":"Noordzij","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Reinier de Graaf Ziekenhuis  Delft The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlies A.","family":"van Houten","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Spaarne Gasthuis  Haarlem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jantien","family":"Wieringa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Haaglanden Medical Centre  Den Haag The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerdien A.","family":"Tramper\u2010Stranders","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Franciscus Gasthuis &amp; Vlietland  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Hira","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infection Prevention Groene Hart Ziekenhuis  Gouda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolita","family":"Bekhof","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Isala ziekenhuis  Zwolle The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke J.","family":"Vet","sequence":"additional","affiliation":[{"name":"Department of Pediatrics St. Antonius Ziekenhuis  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gertjan J. A.","family":"Driessen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"van Veen","sequence":"additional","affiliation":[{"name":"Juliana Children's Hospital, Haga Teaching Hospital  Den Haag The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2020.04.007"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-04015-0"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25582"},{"key":"e_1_2_11_5_1","article-title":"Low levels of respiratory syncytial virus activity in Europe during the 2020\/21 season: what can we expect in the coming summer and autumn\/winter?","volume":"26","author":"Summeren J","year":"2021","journal-title":"Eurosurveillance"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idnow.2021.05.004"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-022-01756-4"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2021-323375"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-053537"},{"key":"e_1_2_11_10_1","volume-title":"RIVM Coronavirus Timeline Netherlands","author":"Rijksoverheid","year":"2022"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.822985"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25644"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgar.2022.01.010"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/irv.12983"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2711.211565"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(21)00333-3"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.02301"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2007.05.047"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201508-545OC"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3345\/kjp.2014.57.1.26"},{"key":"e_1_2_11_21_1","volume-title":"Numbers About Birth","author":"Netherlands Youth Institute.\u00a0","year":"2022"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26327","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.26327","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.26327","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T20:46:00Z","timestamp":1692305160000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.26327"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,2]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1002\/ppul.26327"],"URL":"https:\/\/doi.org\/10.1002\/ppul.26327","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,2]]},"assertion":[{"value":"2022-09-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}