Table 2.
Clinical manifestations of Mycoplasma pneumoniae-associated hospital admissions for 24 h or more in children and adolescents in Denmark before, during and after the COVID-19 pandemic.
| Clinical manifestations of Mycoplasma pneumoniae-associated hospital admission for 24 h or more | ||||
|---|---|---|---|---|
| Pre-COVID-19 seasons |
COVID-19 seasons |
Post-COVID-19 season |
p-value |
|
| 2016–2017, 2017–2018, 2018–2019, 2019–2020 | 2020–2021, 2021–2022, 2022–2023 | 2023–2024 | 2016–2017, 2017–2018, 2018–2019, 2019–2020 versus 2023–2024 | |
| Total number of children and adolescents | 360 | 4 | 230 | - |
| Co-morbiditya | 68 (19%) | - | 43 (19%) | 1.00 |
| Symptoms | ||||
| Fever | 317 (88%) | - | 203 (88%) | 1.00 |
| Cough | 332 (92%) | - | 209 (91%) | 0.67 |
| Dyspnoea | 186 (52%) | - | 112 (49%) | 0.54 |
| Abdominal pain, vomiting, diarrhoea | 92 (26%) | - | 67 (29%) | 0.39 |
| Skin rash | 38 (11%) | - | 29 (13%) | 0.53 |
| Symptoms before hospitalisation (days) | 8 (6–12) | - | 7 (5–11) | 0.15 |
| C-reactive protein, max (mg/L) | 37 (15–90) | - | 46 (14–100) | 0.24 |
| Primary reason for hospitalisation | ||||
| Pulmonary complications | 302 (84%) | 2 | 176 (77%) | 0.0342 |
| Community-acquired pneumonia | 280 (78%) | - | 152 (66%) | 0.0024 |
| Parapneumonic effusion | 3 (1%) | - | 1 (<1%) | - |
| Necrotising pneumonia | 0 (0%) | - | 1 (<1%) | - |
| Bronchiolitis obliterans | 0 (0%) | - | 1 (<1%) | - |
| Treatmentb | ||||
| Macrolides | 310 (86%) | - | 200 (87%) | 0.87 |
| IV antibioticsc | 105 (29%) | - | 66 (29%) | 0.98 |
| Oxygen therapy | 183 (61%) | - | 132 (75%) | 0.0019 |
| Beta-2 agonists | 115 (38%) | - | 74 (42%) | 0.45 |
| Chest tube drainage | 2 (<1%) | - | 1 (<1%) | - |
| Intensive care unit | 12 (4%) | - | 9 (5%) | 0.72 |
| Mechanical ventilation | 6 (2%) | - | 3 (2%) | - |
| Extrapulmonary complications | 58 (16%) | 2 | 54 (23%) | 0.0342 |
| Dermatologicald | 24 (7%) | 2 | 29 (13%) | 0.0207 |
| M pneumoniae-induced rash and mucositis | 16 (4%) | - | 21 (9%) | 0.0344 |
| Angiooedema | 2 (<1%) | - | 5 (2%) | - |
| Gastrointestinal | 19 (5%) | - | 14 (6%) | 0.82 |
| Abdominal pain | 13 (4%) | - | 8 (4%) | - |
| Diarrhoea & vomiting | 6 (2%) | - | 6 (3%) | - |
| Central nervous system | 11 (3%) | - | 8 (3%) | 0.96 |
| Haematological | 1 (<1%) | - | 1 (<1%) | - |
| Renal | 1 (<1%) | - | 2 (<1%) | - |
| Cardiac | 2 (<1%) | - | 0 (0%) | - |
| IV therapy (fluid) | 80 (22%) | - | 50 (22%) | 0.97 |
| PICU | 14 (4%) | - | 9 (4%) | 1.00 |
| Hospitalisation (days) | 3 (2–5) | - | 3 (2–5) | 0.84 |
| Mortality | 0 (0%) | - | 0 (0%) | - |
Data are n (%), median (IQR), or p-value. IV = intravenous, PICU = paediatric intensive care unit. ‘-’ indicates non-applicability. Ten patients with cancer were excluded from the analyses.
Co-morbidity included asthma or other chronic lung diseases, immunosuppressive therapy, chronic heart and neurological disease, metabolic diseases, and haemolytic anaemia.
Proportion of the specified treatment (e.g., oxygen therapy) for pulmonary complications.
2023–2024: IV beta-lactam 55%, IV macrolide 21%, combined treatment 24%. Pre-COVID-19: IV beta-lactam 65%, IV macrolide 11%, combined treatment 24%.
Dermatological complications other than M pneumoniae-induced rash and mucositis and angiooedema was purpuric rash, urticaria, and diffuse erythematous rash (n = 6 in 2016–2017 to 2019–2020 and n = 3 in 2023–2024).