Volume 36, Issue 260 (9-2026)
J Mazandaran Univ Med Sci 2026, 36(260): 44-53 |
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Hajialibeig A, Zabihi M, Varshoei F, Rostami-Maskopaee F, Hosseinzadeh F, Gholipour Varnami S et al . Changes in Pediatric Meningitis Before and After the Onset of the COVID-19 Pandemic: A Retrospective Hospital-Based Study in Northern Iran. J Mazandaran Univ Med Sci 2026; 36 (260) :44-53
URL: http://jmums.mazums.ac.ir/article-1-23055-en.html
URL: http://jmums.mazums.ac.ir/article-1-23055-en.html
Azin Hajialibeig 
, Mahdi Zabihi , Fatemeh Varshoei , Fereshteh Rostami-Maskopaee , Fatemeh Hosseinzadeh , Shahla Gholipour Varnami , Mohammad Sadegh Rezai
, Mahdi Zabihi , Fatemeh Varshoei , Fereshteh Rostami-Maskopaee , Fatemeh Hosseinzadeh , Shahla Gholipour Varnami , Mohammad Sadegh Rezai
Abstract: (34 Views)
Background and purpose: The COVID-19 pandemic affected the epidemiology of infectious diseases. Meningitis in children is a medical emergency, and investigating changes in its epidemiology and clinical characteristics during the pandemic may help prepare healthcare systems for future crises. This study aimed to compare the clinical characteristics and outcomes of pediatric meningitis before and after the onset of the COVID-19 pandemic.
Materials and methods: Data from 134 children hospitalized with a diagnosis of meningitis at Bu-Ali Hospital in Sari between 2015 and 2023 were examined in two groups: those admitted before and those admitted after the onset of the COVID-19 pandemic. Demographic data, clinical manifestations, laboratory findings, antibiotic therapy, intensive care unit (ICU) admission, length of hospital stay, and final outcome were assessed.
Results: A total of 103 patients were admitted before and 31 after the pandemic. The mean annual number of hospitalizations for meningitis decreased from 20.6 cases during the pre-pandemic period to 7.8 cases during the post-pandemic period. Most patients were aged <5 years before the pandemic, whereas approximately half were aged >5 years in the post-pandemic period. A significant decrease in bacterial meningitis and increases in positive CSF cultures and meropenem use were observed in the post-pandemic period (p < 0.05). A toxic appearance was more common in the post-pandemic period; however, after adjusting for age >5 years and bacterial meningitis, its independent association with the pandemic period was not significant. After adjusting for toxic appearance, ICU admission and bacterial meningitis remained independently associated with the post-pandemic period. There were no significant differences between the two periods in mortality, mechanical ventilation, or ICU admission.
Conclusion: Following the onset of the COVID-19 pandemic, the number of pediatric meningitis hospitalizations decreased; however, the patient composition shifted towards a higher proportion of bacterial cases, more frequent positive CSF cultures, and greater use of broad-spectrum antibiotics. These findings highlight the importance of maintaining rapid diagnostic pathways for meningitis, strengthening infectious disease surveillance systems, and continuing antimicrobial stewardship programs during public health crises.
Materials and methods: Data from 134 children hospitalized with a diagnosis of meningitis at Bu-Ali Hospital in Sari between 2015 and 2023 were examined in two groups: those admitted before and those admitted after the onset of the COVID-19 pandemic. Demographic data, clinical manifestations, laboratory findings, antibiotic therapy, intensive care unit (ICU) admission, length of hospital stay, and final outcome were assessed.
Results: A total of 103 patients were admitted before and 31 after the pandemic. The mean annual number of hospitalizations for meningitis decreased from 20.6 cases during the pre-pandemic period to 7.8 cases during the post-pandemic period. Most patients were aged <5 years before the pandemic, whereas approximately half were aged >5 years in the post-pandemic period. A significant decrease in bacterial meningitis and increases in positive CSF cultures and meropenem use were observed in the post-pandemic period (p < 0.05). A toxic appearance was more common in the post-pandemic period; however, after adjusting for age >5 years and bacterial meningitis, its independent association with the pandemic period was not significant. After adjusting for toxic appearance, ICU admission and bacterial meningitis remained independently associated with the post-pandemic period. There were no significant differences between the two periods in mortality, mechanical ventilation, or ICU admission.
Conclusion: Following the onset of the COVID-19 pandemic, the number of pediatric meningitis hospitalizations decreased; however, the patient composition shifted towards a higher proportion of bacterial cases, more frequent positive CSF cultures, and greater use of broad-spectrum antibiotics. These findings highlight the importance of maintaining rapid diagnostic pathways for meningitis, strengthening infectious disease surveillance systems, and continuing antimicrobial stewardship programs during public health crises.
Type of Study: Research(Original) |
Subject:
Pediatric Infectious Disease
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