Exploring the Effects of the COVID-19 Pandemic on Pneumococcal Disease in France: A Comprehensive Analysis of Public Health Impact and Economic Burden

OBJECTIVES: Streptococcus pneumoniae represents a major public health issue in France, leading to many respiratory infections. The Covid-19 pandemic and measures to limit interindividual contacts have led to reduce viral infections (due to influenza and respiratory syncytial virus) and bacterial infections (due to meningococcus and pneumococcus) responsible for respiratory diseases. This study aims to analyse changes in the public health impact and economic burden of pneumococcal disease (PD) before and during the Covid-19 pandemic in France.

METHODS: Based on the national epidemiological and demographic data and published data, the epidemiological burden associated with invasive pneumococcal disease (IPD) and non-invasive PD (including non bacteremic pneumococcal pneumonia (NBPP) and acute otitis media (AOM)) was estimated in children and adults, according to the serotype distribution. The economic impact associated with PD was valued using French national health insurance tariffs and published data.

RESULTS: Before the pandemic, the burden of PD was estimated at 736 meningitis, 6,193 bacteraemia, 209,634 NBPP in the overall population, and 839,357 AOM in children in France. As the related management cost varies greatly depending on the nature and severity of the PD (from €11,216 per meningitis episode to €73 per AOM), the total economic burden of PD was estimated at over €1 million per year. However, the Covid-19 pandemic led to a drastic reduction in the incidence of IPD in France (by more than 40%), changed the bacterial ecology of PD and reduced its economic impact.

CONCLUSIONS: We have developed a comprehensive analysis of the impact of the Covid-19 pandemic on the epidemiological and economic burden of PD in France. While the magnitude of this effect must be interpreted with caution as regards future changes in the global incidence of PD, its long-term impact on the PD’s serotype distribution must be carefully scrutinised.