Pediatric neurology · 2026
Impact of Postpandemic Pediatric Infection Rebound on Febrile Seizures: A Nationwide Cohort Study, 2013-2023.
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Okubo Yusuke, Hayakawa Itaru, Sugitate Ryo, Nariai Hiroki
Аннотация
BACKGROUND: Febrile seizures (FSs) affect younger children and typically accompany common infectious diseases. The COVID-19 pandemic disrupted pediatric infectious disease patterns, yet how these changes have influenced incidence rates of FS and associated health care resource use after the pandemic remains unknown.
METHODS: We conducted a cohort study using a nationwide administrative claims database among children from fiscal year 2013-2023, totaling 5.5 million person-years. We estimated incidence rates of FS, with relevant hospitalization risks, health care costs, and health care resource utilizations using multivariable generalized linear models with direct standardization. Geospatial microsimulation models were used to estimate the national burden of FS over the period.
RESULTS: The incidence rate of FS among children aged 6 months to <5 years was stable at 58.6-69.2 cases per 1000 person-years during 2013-2018, fell by 59.9% in 2020, and rose to 71.7 per 1000 person-years in 2023, surpassing prepandemic levels. The incidence rates of FS changed in direct proportion to the community pediatric infectious disease rates, and the seizure-per-infection risks were identical in 2023 to those observed before the COVID-19 pandemic. Microsimulation models estimated 260,000-340,000 FS episodes, 13,000-16,000 hospitalizations, and 10-12 billion Japanese yen in annual costs before the COVID-19 pandemic, halving in 2020 and recovering to 270,000 episodes, 13,000 admissions, and 10.5 billion Japanese yen by 2023.
CONCLUSIONS: The postpandemic surge in FS reflects restored infection pressure, not heightened host susceptibility. Responsive pediatric care could be guided by real-time infection surveillance to align clinical capacity and resources with shifting community infection burden.
METHODS: We conducted a cohort study using a nationwide administrative claims database among children from fiscal year 2013-2023, totaling 5.5 million person-years. We estimated incidence rates of FS, with relevant hospitalization risks, health care costs, and health care resource utilizations using multivariable generalized linear models with direct standardization. Geospatial microsimulation models were used to estimate the national burden of FS over the period.
RESULTS: The incidence rate of FS among children aged 6 months to <5 years was stable at 58.6-69.2 cases per 1000 person-years during 2013-2018, fell by 59.9% in 2020, and rose to 71.7 per 1000 person-years in 2023, surpassing prepandemic levels. The incidence rates of FS changed in direct proportion to the community pediatric infectious disease rates, and the seizure-per-infection risks were identical in 2023 to those observed before the COVID-19 pandemic. Microsimulation models estimated 260,000-340,000 FS episodes, 13,000-16,000 hospitalizations, and 10-12 billion Japanese yen in annual costs before the COVID-19 pandemic, halving in 2020 and recovering to 270,000 episodes, 13,000 admissions, and 10.5 billion Japanese yen by 2023.
CONCLUSIONS: The postpandemic surge in FS reflects restored infection pressure, not heightened host susceptibility. Responsive pediatric care could be guided by real-time infection surveillance to align clinical capacity and resources with shifting community infection burden.