Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of COVID-19 on Pediatric Intussusception: A Retrospective Study of a Single Center in South Korea with 10-Year Experience

코로나바이러스감염증-2019 유행 후 소아 장중첩증의 변화: 단일기관 10년 의무 기록을 이용한 연구

  • Yeo Jin Yoo (Department of Radiology, Korea University College of Medicine, Ansan Hospital) ;
  • Bo-Kyung Je (Department of Radiology, Korea University College of Medicine, Ansan Hospital) ;
  • Ga Young Choi (Department of Radiology, Korea University College of Medicine, Ansan Hospital) ;
  • Jee Hyun Lee (Department of Pediatrics, Korea University College of Medicine, Ansan Hospital) ;
  • Sunkyu Choi (Department of Biostatistics, Korea University College of Medicine) ;
  • Ji Young Lee (Department of Radiology, Inje University College of Medicine, Ilsan Paik Hospital)
  • 유여진 (고려대학교 의과대학 안산병원 영상의학과) ;
  • 제보경 (고려대학교 의과대학 안산병원 영상의학과) ;
  • 최가영 (고려대학교 의과대학 안산병원 영상의학과) ;
  • 이지현 (고려대학교 의과대학 안산병원 소아청소년과) ;
  • 최선규 (고려대학교 의과대학 의학통계학교실) ;
  • 이지영 (인제대학교 의과대학 일산백병원 영상의학과)
  • Received : 2021.05.14
  • Accepted : 2021.10.06
  • Published : 2022.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose To evaluate the effect of the emergence of coronavirus disease-19 (COVID-19) on pediatric intussusception. Materials and Methods Patients (< 18 years) who were diagnosed with intussusception and received enema reduction from 2011 to 2020 were included. We reviewed the demographics, yearly/monthly/seasonal incidence of intussusception, method and failure rate of enema reduction, recurrence rate of intussusception, surgical record, and pathologic report. Subsequently, we investigated the differences in mean age, failure rate of enema reduction, and recurrence rate of intussusception between the cases in 2020 and those in the period from 2011 to 2019. Results A total of 859 enema reductions were performed during the past decade, more in males and in the age < 1 year (mean age, 22.2 months). The yearly incidence was highest in 2014 and lowest in 2020, and the monthly incidence was highest on December and September. The cases in 2020 (n = 27) had a lower mean age (18.1 months vs. 22.8 months), higher failure rate of enema reduction (7.4% vs. 2.4%), and higher recurrence rate of intussusception (14.8% vs 7.3%) compared with those that occurred between 2011 and 2019 (n = 832). However, these results did not show statistical significance (p = 0.07, p = 0.15, p = 0.14, respectively). Conclusion With the emergence of COVID-19, the number of enema reductions was remarkably decreased with a lower mean age, higher failure rate, and higher recurrence rate.

목적 코로나바이러스감염증-19 영향으로 소아청소년과 내원 환자 수가 현저히 감소한 2020년에 소아 장중첩증에는 어떤 변화가 발생했는지 알아보고자 한다. 대상과 방법 2011년부터 2020년까지 고려대학교 안산병원에 내원하여 장중첩증 진단 후 관장정복술을 받은 18세 미만의 환자의 성별, 나이, 관장정복술의 연도별/월별/계절별 빈도, 관장정복술의 연도별/월별 실패율, 장중첩증의 연도별/월별 재발률을 조사하였다. 또한 2011-2019년에 내원한 환자군과 2020년에 내원한 환자군 사이에 평균 나이, 관장정복술 실패율 및 장중첩증 재발률에서 통계적 차이가 있는지 분석하였다. 결과 10년간 859건의 관장정복술은 남아에서 더 많이 시행되었고 평균 나이는 22.2개월, 연령별로는 1세 미만이 가장 많았다. 연도별 빈도는 2014년에 가장 높았고 2020년에 가장 낮았으며, 월별 빈도는 12월과 9월이 높았고 3월이 가장 낮았다. 2020년 환자군(n = 27)은 2011-2019년 환자군(n = 832)에 비해 평균 나이가 어리고(18.1개월 vs. 22.8개월) 관장정복술 실패율이 높고 (7.4% vs. 2.4%) 장중첩증 재발률이 높았으나(14.8% vs. 7.3%) 통계적 유의성을 보이지는 않았다(p = 0.07, p = 0.15, p = 0.14). 결론 코로나바이러스감염증-19가 유행한 2020년에는 장중첩증으로 관장정복술을 받은 환자수가 급격히 감소하였고, 지난 10년의 기록과 비교할 때 환자의 나이가 더 어린 경향을 보였으며, 관장정복술의 실패율과 장중첩증 재발률은 가장 높은 수치를 기록하였다.

Keywords

References

  1. Ministry of Health and Welfare. Coronavirus (COVID-19). Available at. http://ncov.mohw.go.kr. Accessed Apr 5, 2021 
  2. Ministry of Education. Press release. Available at. https://www.moe.go.kr/boardCnts/viewRenew.do?boardID=294&boardSeq=79829&lev=0&searchType=null&statusYN=W&page=98&s=moe&m=020402&opType=N. Published Feb 23, 2020. Accessed Apr 4, 2021 
  3. Health Insurance Review & Assessment Service. Statistics on medical expenses. Available at. https://www. hira.or.kr/bbsDummy.do?pgmid=HIRAA020045010000&brdScnBltNo=4&brdBltNo=2343&pageIndex=2. Published Mar 25, 2021. Accessed Apr 5, 2021 
  4. Parashar UD, Holman RC, Cummings KC, Staggs NW, Curns AT, Zimmerman CM, et al. Trends in intussusception-associated hospitalizations and deaths among US infants. Pediatrics 2000;106:1413-1421 
  5. Bines JE, Kohl KS, Forster J, Zanardi LR, Davis RL, Hansen J, et al. Acute intussusception in infants and children as an adverse event following immunization: case definition and guidelines of data collection, analysis, and presentation. Vaccine 2004;22:569-574 
  6. Jiang J, Jiang B, Parashar U, Nguyen T, Bines J, Patel MM. Childhood intussusception: a literature review. PLoS One 2013;8:e68482 
  7. Lee EH, Yang HR. Nationwide population-based epidemiologic study on childhood intussusception in South Korea: emphasis on treatment and outcomes. Pediatr Gastroenterol Hepatol Nutr 2020;23:329-345 
  8. Kim JS, Lee SK, Ko DH, Hyun J, Kim HS, Song W, et al. Associations of adenovirus genotypes in Korean acute gastroenteritis patients with respiratory symptoms and intussusception. Biomed Res Int 2017;2017:1602054 
  9. Jang J, Lee YJ, Kim JS, Chung JY, Chang S, Lee K, et al. Epidemiological correlation between fecal adenovirus subgroups and pediatric intussusception in Korea. J Korean Med Sci 2017;32:1647-1656 
  10. Moore SW, Kirsten M, Muller EW, Numanoglu A, Chitnis M, Le Grange E, et al. Retrospective surveillance of intussusception in South Africa, 1998-2003. J Infect Dis 2010;202 Suppl:S156-S161 
  11. Bell TM, Steyn JH. Viruses in lymph nodes of children with mesenteric adenitis and intussusception. Br Med J 1962;2:700-702 
  12. Pang LC. Intussusception revisited: clinicopathologic analysis of 261 cases, with emphasis on pathogenesis. South Med J 1989;82:215-228 
  13. Robinson CG, Hernanz-Schulman M, Zhu Y, Griffin MR, Gruber W, Edwards KM. Evaluation of anatomic changes in young children with natural rotavirus infection: is intussusception biologically plausible? J Infect Dis 2004;189:1382-1387 
  14. Korea Disease Control and Prevention Agency. Infectious disease portal. Available at. https://www.kdca.go.kr/npt/biz/npp/iss/influenzaStatisticsMain.do. Accessed Apr 5, 2021 
  15. Choi S, Ki M. Analyzing the effects of social distancing on the COVID-19 pandemic in Korea using mathematical modeling. Epidemiol Health 2020;42:e2020064 
  16. Baek S, Lee J, Park K, Lee E, Park S, Lee S, et al. Results of the national infectious disease surveillance, from January to April 2020. Korean Disease Control and Prevention Agency 2020;13:1491-1502 
  17. Ministry of Education. Press release. Available at. https://www.moe.go.kr/boardCnts/viewRenew.do?boardID=294&boardSeq=84339&lev=0&searchType=null&statusYN=W&page=34&s=moe&m=020402&opType=N. Published May 10, 2021. Accessed May 10, 2021 
  18. Jo S, Lim IS, Chae SA, Yun SW, Lee NM, Kim SY, et al. Characteristics of intussusception among children in Korea: a nationwide epidemiological study. BMC Pediatr 2019;19:211 
  19. Guo WL, Zhang SF, Li JE, Wang J. Association of meteorological factors with pediatric intussusception in subtropical china: a 5-year analysis. PLoS One 2014;9:e90521 
  20. Spijkers S, Staats JM, Littooij AS, Nievelstein RAJ. Abdominal lymph node size in children at computed tomography. Pediatr Radiol 2020;50:1263-1270 
  21. Hsu WL, Lee HC, Yeung CY, Chan WT, Jiang CB, Sheu JC, et al. Recurrent intussusception: when should surgical intervention be performed? Pediatr Neonatol 2012;53:300-303 
  22. Fisher JG, Sparks EA, Turner CG, Klein JD, Pennington E, Khan FA, et al. Operative indications in recurrent ileocolic intussusception. J Pediatr Surg 2015;20:126-130 
  23. Kim JY, Imaging findings of gastrointestinal emergency in infants and young children. J Korean Soc Radiol 2020;81:794-805 
  24. Gray MP, Li SH, Hoffmann RG, Gorelick MH. Recurrence rates after intussusception enema reduction: a meta-analysis. Pediatrics 2014;134:110-119 
  25. Ma GMY, Lillehei C, Callahan MJ. Air contrast enema reduction of single and recurrent ileocolic intussusceptions in children: patterns, management and outcomes. Pediatr Radiol 2020;50:664-672 
  26. Xie X, Wu Y, Wang Q, Zhao Y, Xiang B. Risk factors for recurrence of intussusception in pediatric patients: a retrospective study. J Pediatr Surg 2018;53:2307-2311 
  27. Ye X, Tang R, Chen S, Lin Z, Zhu J. Risk factors for recurrent intussusception in children: a systematic review and meta-analysis. Front Pediatr 2019;7:145 
  28. Vo A, Levin TL, Taragin B, Khine H. Management of intussusception in the pediatric emergency department: risk factors for recurrence. Pediatr Emerg Care 2020;36:e185-e188