Epidemiological and clinical characteristics of hospitalized pediatric patients with Mycoplasma pneumoniae pneumonia before and after the COVID-19 pandemic in China: a retrospective multicenter study

Yuqian Zhang; Chenglei Su; Yang Zhang; Shuo Ding; Xianliang Yan; Jianguo Zhang; Zhimin Tao

doi:10.1186/s12879-024-10370-8

Epidemiological and clinical characteristics of hospitalized pediatric patients with Mycoplasma pneumoniae pneumonia before and after the COVID-19 pandemic in China: a retrospective multicenter study

BMC Infect Dis. 2025 Jan 3;25(1):18. doi: 10.1186/s12879-024-10370-8.

Authors

Yuqian Zhang¹, Chenglei Su², Yang Zhang³, Shuo Ding⁴, Xianliang Yan^{2

3}, Jianguo Zhang⁵, Zhimin Tao^{6

7}

Affiliations

¹ Department of Emergency Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China.
² Department of Emergency Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221000, China.
³ Department of Emergency Medicine, Suining County People's Hospital, Xuzhou, Jiangsu, 221200, China.
⁴ Department of Emergency Medicine, Fengxian County People's Hospital, Xuzhou, Jiangsu, 221700, China.
⁵ Department of Emergency Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China. 1000011431@ujs.edu.cn.
⁶ Department of Emergency Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 212001, China. jsutao@ujs.edu.cn.
⁷ Jiangsu Province Key Laboratory of Medical Science and Laboratory Medicine, Department of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu, 212013, China. jsutao@ujs.edu.cn.

Abstract

Background: In China many respiratory pathogens stayed low activities amid the COVID-19 pandemic due to strict measures and controls. We here aimed to study the epidemiological and clinical characteristics of pediatric inpatients with Mycoplasma pneumoniae pneumonia (MPP) after the mandatory COVID-19 restrictions were lifted, in comparison to those before the COVID-19 pandemic.

Methods: We here included 4,296 pediatric patients with MPP, hospitalized by two medical centers in Jiangsu Province, China, from January 2015 to March 2024. Patients were divided into the pre-COVID (n = 1,662) and post-COVID (n = 2,634) groups. Their baseline characteristics, laboratory test results and radiological patterns were separately assessed and compared between the two groups to determine the substantial changes in the disease profile of MPP after the COVID-19 pandemic.

Results: Epidemiological results suggested a higher annual incidence of MPP after the COVID-19 pandemic when the outbreak reached a peak in October, two months delayed in seasonality compared to that in the pre-COVID era. For pediatric patients with MPP, there was no difference in their median ages, gender ratios, and severe case percentages between the two groups, where most patients were younger than 14 years old. With significance, the post-COVID group had more occurrences of cough and expectoration and higher incidences of influenza A/B virus (IAV/IBV) co-infection than the pre-COVID group. Many hematological parameters and radiological features between the two groups displayed alteration, but comparatively there demonstrated no worsened severity in hospitalized children with MPP after COVID-19 pandemic. Concurrently, the post-COVID group was administered with fewer antibiotics but more corticosteroids for effective treatment than the pre-COVID group.

Conclusion: Through the COVID-19 pandemic, the epidemiological and clinical characteristics of pediatric patients with MPP differed, but there was no evident change in the disease severity. After the COVID-19 pandemic, the increased incidence of IAV/IBV co-infection may contribute to the differences in clinical symptoms and hematological profiles, while the adding usage of corticosteroids might treat more effectively.

Keywords: Mycoplasma pneumoniae; COVID-19 pandemic; Macrolide resistance; Pediatric hospitalization; Pneumonia.