Details of a Researcher - TUGAWA Takesi

Papers - TUGAWA Takesi

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「データベースを用いた国内発症小児Coronavirus Disease 2019(COVID-19)症例の臨床経過に関する検討」最終報告

勝田友博, 天羽清子, 荒木かほる, 石和田稔彦, 大宜見力, 大城誠, 神谷元, 越田理恵, 清水直樹, 高野智子, 津川毅, 富樫篤生, 中野貴司, 西村直子, 野崎昌俊, 菱木はるか, 藤岡雅司, 保科隆之, 細矢光亮, 前田明彦, 水野由美, 宮崎雅仁, 吉川哲史, 和田泰三, 岩田敏, 尾内一信, 岡田賢司, 是松聖悟, 菅秀, 宮崎千明, 森内浩幸, 齋藤昭彦, 塚原宏一, 森岡一朗, 宮入烈, 多屋馨子, 日本小児科学会予防接種・感染症対策委員会

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 128 ( 5 ) 777 - 783 2024.05

Children's cognition and attitudes during long-term cancer treatment: an ethnographic study.

Ryoko Michinobu, Masaki Yamamoto, Keita Igarashi, Yoshiyuki Sakai, Yusuke Akane, Dai Yamamoto, Akira Takebayashi, Takahiro Mikami, Hiroyuki Tsutsumi, Takeshi Tsugawa

BMJ paediatrics open 8 ( 1 ) 2024.04 [Refereed] [International journal]

Authorship： Last author

BACKGROUND: Cancer treatment for children is typically long-term and difficult, and the experience is unique for each child. When designing child-centred care, individuals' values and preferences are considered equally important as the clinical evidence; therefore, understanding children's thoughts and attitudes while they receive long-term treatment could offer valuable insights for better clinical practice. METHODS: We conducted long-term consecutive participatory observations and interviews with seven children, who were hospitalised and receiving cancer treatment for the first time. The daily observational data on those children's discourses, behaviours and interactions with health professionals were systematically collected and thematically examined. The analysis was expanded to explore significant narratives for each child to capture their narrative sequence over time. RESULTS: The initial analysis identified 685 narrative indexes for all observation data, which were categorised into 21 sub-codes. Those sub-codes were assembled into five main themes by thematic analysis: making promises with health professionals, learning about the treatment procedures through participation, taking care of oneself, increasing the range of activities one can perform and living an ordinary life. CONCLUSION: We observed a forward-looking attitude toward understanding cancer, accepting treatment and looking forward to the future among children undergoing in-hospital cancer treatment. In addition, the children developed cognitively, affectively and relationally throughout cancer treatment processes. These findings have implications for better clinical practice in child-centred care, including children's participation in shared decision-making in paediatric oncology.

DOI PubMed

Severe cervical abscess due to PVL-positive ST6562 MRSA-IVa, a presumptive variant of ST8-IVa USA300 clone in northern Japan.

Katsumasa Kudo, Takahiro Noda, Yuta Sasaoka, Atsuo Togashi, Meiji Soe Aung, Yoshiyuki Sakai, Takeshi Tsugawa, Nobumichi Kobayashi

New microbes and new infections 58 101230 - 101230 2024.04 [Refereed] [International journal]

DOI PubMed

Effects of probiotics in children with acute gastroenteritis: A systematic review and meta-analysis focusing on probiotics utilized in Japan.

Toru Higuchi, Munehiro Furuichi, Naonori Maeda, Takeshi Tsugawa, Kenta Ito

Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 30 ( 4 ) 337 - 342 2024.04 [Refereed] [International journal]

BACKGROUND: Many randomized controlled trials and systematic reviews have evaluated the use of probiotics to treat acute infectious gastroenteritis. However, most probiotic species evaluated in previous large randomized controlled trials are unavailable in Japan. Our objective was to investigate the efficacy of probiotics utilized in Japan for acute gastroenteritis. METHODS: The inclusion criterion was a randomized controlled study that compared probiotics with a placebo to treat children younger than 18 years with acute infectious gastroenteritis. We excluded studies that did not contain the following species available in Japan: Bifidobacterium spp., Lactobacillus acidophilus, Enterococcus faecium, Clostridium butyricum, and Bacillus subtilis and studies in low- or lower-middle-income countries. We searched PubMed, CENTRAL, and Igaku Chuo Zasshi from their inception to November 27, 2022. After the risk of bias assessment, data on diarrhea duration, number of hospitalizations, length of hospital stay, and adverse effects were extracted. RESULTS: Fourteen studies were included in this meta-analysis. Diarrhea lasting longer than 48 h (7 articles, n = 878) was significantly lower in the probiotic group (risk ratio (RR) 0.70, 95 % confidence interval (CI) 0.59-0.83). The duration of diarrhea (14 articles; n = 1761) was 23.45 h (95 % CI 18.22-26.69) shorter in the probiotic group. Duration of hospitalization (6 articles; n = 971) was 17.73 h (95 % CI 6.9-28.56) shorter in the probiotic group. CONCLUSIONS: Although the certainty of evidence is very low, the use of probiotics for acute gastroenteritis in children may improve diarrhea approximately one day earlier. This study was registered with PROSPERO (CRD 42023405559).

DOI PubMed

「原因不明の小児急性肝炎に関する実態調査(二次調査)」報告

近藤宏樹, 多屋馨子, 天羽清子, 乾あやの, 笠原群生, 鈴木光幸, 田中孝明, 津川毅, 別所一彦, 保科隆之, 宮入烈, 虫明聡太郎, 吉川哲史, 齋藤昭彦, 塚原宏一, 森岡一朗, 須磨崎亮, 細矢光亮, 日本小児科学会予防接種・感染症対策委員会原因不明の小児の急性肝炎対策ワーキンググループ

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 128 ( 4 ) 668 - 680 2024.04

COVID-19パンデミック期の小児の急性肝炎原因不明の小児急性肝炎対策ワーキンググループのこれまでの活動と調査結果に関する報告

近藤宏樹, 多屋馨子, 天羽清子, 乾あやの, 笠原群生, 齋藤昭彦, 鈴木光幸, 田中孝明, 塚原宏一, 津川毅, 別所一彦, 保科隆之, 宮入烈, 森岡一朗, 吉川哲史, 虫明聡太郎, 須磨崎亮, 細矢光亮

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 128 ( 2 ) 165 - 165 2024.02

おたふくかぜワクチン接種後の副反応に関する全国調査報告

神谷元, 西藤成雄, 中野貴司, 菅秀, 奥山舞, 田中敏博, 中村豊, 森野紗衣子, 高梨さやか, 新井智, 木所稔, 岡田賢司, 天羽清子, 荒木かほる, 石和田稔彦, 大宜見力, 勝田友博, 越田理恵, 高野智子, 津川毅, 富樫篤生, 西村直子, 野崎昌俊, 菱木はるか, 保科隆之, 細矢光亮, 前田明彦, 水野由美, 宮崎雅仁, 吉川哲史, 和田泰三, 岩田敏, 尾内一信, 是松聖悟, 清水直樹, 森内浩幸, 宮崎千明, 宮入烈, 森岡一朗, 塚原宏一, 齋藤昭彦, 多屋馨子, 日本小児科学会予防接種・感染症対策委員会

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 128 ( 1 ) 92 - 104 2024.01

2020年1月から2023年3月までに1歳以上就学前の小児に対して乾燥弱毒生おたふくかぜワクチン(おたふくかぜワクチン)接種を行った医師を対象に、接種8週間後までの副反応が疑われる症状に関して情報収集を行った。8週間フォローできた58783例における無菌性髄膜炎(8例)・急性脳炎(1例)・髄膜脳炎(1例)・無菌性髄膜炎疑い(2例)の発生報告頻度は0.020%であり、前向きに8週間フォローできた44708例では無菌性髄膜炎(疑い2例を含む)6例の発生報告頻度は0.013%であった。頻度は低いものの、おたふくかぜワクチン株が検出された症例で急性脳炎やけいれん重積を認めた症例があったこと、1回目接種後に髄膜炎を疑う症状が一定の頻度で発生していたこと、無菌性髄膜炎6例(疑いを含む)のうち5例が1回目接種後に発生していたことなどが報告された。

Changing Patterns of Infectious Diseases Among Hospitalized Children in Hokkaido, Japan, in the Post-COVID-19 Era, July 2019 to June 2022.

Yuya Fukuda, Atsuo Togashi, Satoshi Hirakawa, Masaki Yamamoto, Shinobu Fukumura, Tomohiro Nawa, Saho Honjo, Jun Kunizaki, Kouhei Nishino, Toju Tanaka, Toshitaka Kizawa, Dai Yamamoto, Ryoh Takeuchi, Yuta Sasaoka, Masayoshi Kikuchi, Takuro Ito, Kazushige Nagai, Hirofumi Asakura, Katsumasa Kudou, Masaki Yoshida, Takeshi Nishida, Takeshi Tsugawa

The Pediatric infectious disease journal 42 ( 9 ) 766 - 773 2023.09 [Refereed] [International journal]

Authorship： Last author

BACKGROUND: Many reports have reported a reduction in respiratory infectious diseases and infectious gastroenteritis immediately after the coronavirus disease 2019 (COVID-19) pandemic, but data continuing into 2022 are very limited. We sought to understand the current situation of various infectious diseases among children in Japan as of July 2022 to improve public health in the post-COVID-19 era. METHODS: We collected data on children hospitalized with infectious diseases in 18 hospitals in Japan from July 2019 to June 2022. RESULTS: In total, 3417 patients were hospitalized during the study period. Respiratory syncytial virus decreased drastically after COVID-19 spread in early 2020, and few patients were hospitalized for it from April 2020 to March 2021. However, an unexpected out-of-season re-emergence of respiratory syncytial virus was observed in August 2021 (50 patients per week), particularly prominent among older children 3-6 years old. A large epidemic of delayed norovirus gastroenteritis was observed in April 2021, suggesting that the nonpharmaceutical interventions for COVID-19 are less effective against norovirus. However, influenza, human metapneumovirus, Mycoplasma pneumoniae , and rotavirus gastroenteritis were rarely seen for more than 2 years. CONCLUSIONS: The incidence patterns of various infectious diseases in Japan have changed markedly since the beginning of the COVID-19 pandemic to the present. The epidemic pattern in the post-COVID-19 era is unpredictable and will require continued careful surveillance.

DOI PubMed

Rivaroxaban for severe superior sagittal sinus thrombosis in a child with ALL.

Masaki Yamamoto, Yusuke Akane, Ryo Hamada, Hiroyuki Kabutoya, Keita Igarashi, Sangnyon Kim, Takeshi Tsugawa

International journal of hematology 118 ( 3 ) 309 - 310 2023.09 [Refereed] [Domestic journal]

Authorship： Last author

DOI PubMed

Acute osteomyelitis/septic pulmonary embolism associated with familial infections caused by PVL-positive ST6562 MRSA-IVa, a presumptive variant of USA300 clone.

Nao Harada, Atsuo Togashi, Meiji Soe Aung, Jun Kunizaki, Kazutaka Nogami, Yoshinobu Nagaoka, Akira Ishii, Ima Kosukegawa, Wakiko Aisaka, Satoshi Nakamura, Tomohiro Wakabayashi, Takeshi Tsugawa, Nobumichi Kobayashi

IJID regions 8 16 - 18 2023.09 [Refereed] [International journal]

Panton-Valentine leukocidin (PVL)-positive methicillin-resistant Staphylococcus aureus (MRSA) occasionally causes severe invasive infections. A 10-year-old immunocompetent boy in Hokkaido, the northern main island of Japan, was admitted with acute osteomyelitis of the right ilium, complicated by septic thrombophlebitis of the right common iliac vein and septic pulmonary embolism. As MRSA was isolated from blood and sputum samples of the patient, linezolid and vancomycin were initially used for treatment, and later clindamycin was added based on PCR-positive results for PVL genes. During his hospitalization, the patient was complicated by abscesses around the right ilium and septic arthritis of the right hip, which required surgical drainage. Prior to his admission, his youngest sister had developed a right breast abscess, and another sister and his mother developed contagious impetigo and hordeolum, respectively, during his hospitalization. These infections in the patient and his family members were caused by an identical PVL-positive MRSA strain belonging to ST6562, a single-locus variant of ST8. Due to the genetically close characteristics, this ST6562 MRSA was considered a genetic variant of the USA300 CA-MRSA clone (ST8-MRSA-IVa) predominating in the United States. The ST6562 MRSA-IVa is suggested to have occurred in Japan, associated with potential spread of the USA300 clone.

DOI PubMed

Therapeutic efficacy of intravenous infusion of mesenchymal stem cells in rat perinatal brain injury.

Kojiro Terada, Masanori Sasaki, Hiroshi Nagahama, Yuko Kataoka-Sasaki, Shinichi Oka, Ryo Ukai, Takahiro Yokoyama, Yusuke Iizuka, Takuro Sakai, Shinobu Fukumura, Takeshi Tsugawa, Jeffery D Kocsis, Osamu Honmou

Pediatric research 2023.07 [Refereed] [International journal]

BACKGROUND: Perinatal brain injury is multifactorial and primarily associated with brain prematurity, inflammation, and hypoxia-ischemia. Although recent advances in perinatal medicine have improved the survival rates of preterm infants, neurodevelopmental disorders remain a significant complication. We tested whether the intravenous infusion of mesenchymal stem cells (MSCs) had therapeutic efficacy against perinatal brain injury in rats. METHODS: Pregnant rats at embryonic day (E) 18 received lipopolysaccharide and the pups were born at E21. On postnatal day (PND) 7, the left common carotid artery of each pup was ligated, and they were exposed to 8% oxygen for 2 h. They were randomized on PND10, and MSCs or vehicle were intravenously infused. We performed behavioral assessments, measured brain volume using MRI, and performed histological analyses on PND49. RESULTS: Infused MSCs showed functional improvements in our model. In vivo MRI revealed that MSC infusion increased non-ischemic brain volume compared to the vehicle group. Histological analyses showed that cortical thickness, the number of NeuN+ and GAD67+ cells, and synaptophysin density in the non-ischemic hemisphere in the MSC group were greater than the vehicle group, but less than the control group. CONCLUSIONS: Infused MSCs improve sensorimotor and cognitive functions in perinatal brain injury and enhance neuronal growth. IMPACT: Intravenous infusion of MSCs improved neurological function in rats with perinatal brain injury, including motor, sensorimotor, cognitive, spatial, and learning memory. Infused MSCs increased residual (non-ischemic) tissue volume, number of neuronal cells, GABAergic cells, and cortical synapses in the contralesional (right) hemisphere. Intravenous administration of MSC might be suitable for the treatment of perinatal brain injury.

DOI PubMed

原因不明の小児急性肝炎に関する実態調査(一次調査)報告書

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 127 ( 7 ) 1033 - 1038 2023.07

2022年より欧米から「原因不明の小児急性肝炎」について多くの報告があがるようになり、アデノウイルスや新型コロナウイルス感染症(COVID-19)流行との関連が疑われている。これまで本邦では小児の急性肝炎のサーベイランスが行われていないことから、今回、日本小児科学会会員が所属する全国の病院小児科責任者を対象に、2017年1月～2022年6月までの期間における同疾患の実態について質問紙調査を行い、947名より回答を得た。その結果、COVID-19流行前の報告数は2017年260名、2018年257名、2019年243名で、COVID-19流行中の報告数は2020年164名、2021年192名、2022年1～6月で113名と、COVID-19流行中の方が少ない傾向がみられた。COVID-19流行前は0歳および1～4歳群の症例数が他の年齢群と比較して多い傾向がみられたが、流行中はこれらの年齢群で減少が著明であった。地域別では、COVID-19流行前・流行後ともに、京都府・愛知県・福島県からの報告が多かった。

原因不明の小児急性肝炎に関する実態調査(一次調査)報告書

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 127 ( 7 ) 1033 - 1038 2023.07

小児科医に潜在するワクチン忌避(Vaccine Hesitancy)に対する教育プログラム

勝田友博, 天羽清子, 荒木かほる, 石和田稔彦, 大宜見力, 神谷元, 越田理恵, 高野智子, 津川毅, 富樫篤生, 中野貴司, 西村直子, 野崎昌俊, 菱木はるか, 保科隆之, 細矢光亮, 前田明彦, 水野由美, 宮入烈, 宮崎雅仁, 吉川哲史, 和田泰三, 岩田敏, 尾内一信, 岡田賢司, 岡部信彦, 是松聖悟, 清水直樹, 菅秀, 宮崎千明, 森内浩幸, 大城誠, 藤岡雅司, 森岡一朗, 塚原宏一, 齋藤昭彦, 多屋馨子, 日本小児科学会予防接種・感染症対策委員会

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 127 ( 5 ) 787 - 794 2023.05

予防接種後有害事象(AEFI)および予防接種ストレス関連反応(ISRR)に関連する動画講義視聴が小児科医の予防接種に対する知識、態度、自信、役割認識、自己効力感、行動に与える影響を調査した。介入前評価(pre study)に回答した日本小児科学会会員368名をA群とB群に分けてA群にのみオンラインでISRRに関する約20分間の動画講義を配布し、pre studyから約1ヵ月後にA群・B群に介入後評価(Post study)を行った。Post studyの回答者A群74名、B群95名を対象に動画講義視聴による介入効果について検討した。その結果、AEFIおよびISRRに関連する調査によってA群・B群の知識レベルが向上したが、予防接種に対する態度、自信、役割認識、自己効力感、実際の接種行動に与える影響は限定的であった。

高クレアチンキナーゼ血症から偶発的に診断されたベッカー型7例を含む筋ジストロフィー9例の臨床的検討

伊藤拓郎, 福村忍, 土田晃輔, 山本晃代, 津川毅, 安藤悠開, 下村遼太郎, 飯塚裕典, 星野恵美子, 櫻井のどか, 平川賢史, 布施茂登, 森俊彦

臨床小児医学 ( (財)小児愛育協会 ) 70 ( 1-6 ) 15 - 19 2023.03 [Refereed]

筋ジストロフィー(muscular dystrophy;MD)は,偶発的に高クレアチンキナーゼ(creatine kinase;CK)血症でみつかることがある。今回,明らかな運動発達遅滞がなく偶発的に高CK血症でMDと診断された9例について後方視的に検討した。性別は全例男性であり,診断名は8例がジストロフィン異常症(ベッカー型7例,中間型1例),1例がカルパイン異常症であった。また,9例中5例の患者で家族から運動の苦手さを指摘されていなかった。発見時CKは,中央値15,489.5U/L(499～30,480U/L)だった。うちベッカー型MDの1例はCKの中央値が1,589U/L(56～3,122U/L)で,非感染時の採血でCK値が正常化していた。4例がDMD遺伝子MLPA(multiplex ligation-dependent probe amplification)法で変異がみつからず,筋生検で診断された。本人への告知は4例に行い,2例が12歳,2例が15歳時だった。全例告知後の受け入れは良好だった。本人への告知の時期は中学生頃を目処に,児の理解力と家族の支援体制を総合的に考慮して行う必要がある。(著者抄録)

交通外傷を契機に発症した甲状腺クリーゼの女児例

下村遼太郎, 石井玲, 高尾魁, 萩原絢哉, 北田文華, 千葉充将, 津川毅

臨床小児医学 ( (財)小児愛育協会 ) 70 ( 1-6 ) 51 - 56 2023.03 [Refereed]

Authorship： Last author

甲状腺クリーゼ(thyroid storm;TS)は,何らかの誘因によりコントロール不良の甲状腺中毒症が増悪し,甲状腺ホルモン過剰への代償不全から多臓器不全に至る病態である。致死率は10%を超え,早期の介入が求められる。誘因として抗甲状腺薬のアドヒアランス不良,感染症,手術や外傷などのストレスがあるが,交通外傷に続発した報告は少ない。今回,われわれは交通外傷を契機に発症したTSの女児例を経験した。症例は13歳女児,交通外傷で当院救急部へ搬送され,顔面頸部を含む多発骨折に対して緊急手術を実施された。搬入時から発熱,頻脈を認めていたが,術後も持続し不穏状態も遷延した。入院9日目,FT4 5.82ng/dL,TSH<0.01μIU/mLが判明し,当科へコンサルトされた。未受診のBasedow病を背景としたTSの診断に至り,治療を開始し速やかに症状の改善を得た。交通外傷後の発熱や頻脈,意識障害の鑑別は多岐にわたるが,TSは予後も考慮し早期に鑑別にあげる必要がある。(著者抄録)

Bacillus Calmette-Guérin-induced lupus vulgaris in a patient with Mendelian susceptibility to mycobacterial disease caused by a novel STAT1 variation.

Aika Shionoya, Yuko Yoto, Tokimasa Hida, Aki Ishikawa, Tadashi Hasegawa, Takeshi Tsugawa, Hisashi Uhara

The British journal of dermatology 188 ( 1 ) 142 - 143 2023.01 [Refereed] [International journal]

DOI PubMed

Parental Decision-Making in Cancer Therapy: A Long-Term Observational Study.

Ryoko Michinobu, Masaki Yamamoto, Yoshiyuki Sakai, Takahiro Mikami, Keita Igarashi, Kotoe Iesato, Akira Takebayashi, Tsukasa Hori, Hiroyuki Tsutsumi, Takeshi Tsugawa

Clinical pediatrics 99228221150606 - 99228221150606 2023.01 [Refereed] [International journal]

Authorship： Last author

Parental participation in shared decision-making in children's cancer therapy is essential because parents advocate for and support their children's wishes. However, little research has focused on this issue. We conducted a longitudinal observational study of 7 parents whose child had received their first cancer treatment. We recorded parents' behaviors, interactions, and narratives in 1 pediatric ward and 2 outpatient clinics. The recordings were systematically conducted and thematically analyzed using variable-oriented and process-oriented modes to assess the causal relationships among phenomena. We found 4 themes describing the processes by which parents developed and participated in shared decision-making. The first 2 themes reflected the development of reciprocal parental relationships and parent-other child relationships. These 2 types of relationship generated mutual trust and a sense of solidarity among parents (the third theme). This, in turn, became the foundation for parents to share decision-making with health care professionals (the fourth theme).

DOI PubMed

Sequence analysis of a feline- and porcine-origin G3P[9] rotavirus A strain in a child with acute gastroenteritis in Japan.

Yuya Fukuda, Kaoru Araki, Megumi Hara, Yuji Yamashita, Shuhei Adachi, Saho Honjo, Atsuo Togashi, Satoshi Hirakawa, Shinobu Fukumura, Masaki Yamamoto, Takeshi Tsugawa

Archives of virology 168 ( 2 ) 45 - 45 2023.01 [Refereed] [International journal]

Authorship： Last author , Corresponding author

We isolated the rare G3P[9] rotavirus strain RVA/Human-wt/JPN/R11-035/2015/G3P[9] from a 2-year-old girl presenting with vomiting and diarrhea who had daily contact with cats in Japan, 2015. Full-genome analysis revealed that the R11-035 strain had an AU-1-like genetic constellation, except for the NSP3 (T) gene: G3-P[9]-I3-R3-C3-M3-A3-N3-T1-E3-H6. Phylogenetic analysis showed that strain R11-035 is closely related to human/feline-like human strains, and only the NSP3 (T1) gene was clustered together with Taiwanese porcine strains. We postulate that the R11-035 strain was directly transmitted from a cat to the patient and acquired its NSP3 gene through intergenotype reassortment with porcine strains before being transmitted to humans.

DOI PubMed

コロナウイルス感染症2019流行下における国内小児医療の現状に関する調査

中村幸嗣, 勝田友博, 清水直樹, 神谷元, 天羽清子, 大城誠, 菅秀, 津川毅, 西村直子, 菱木はるか, 藤岡雅司, 細矢光亮, 水野由美, 吉川哲史, 和田泰三, 石和田稔彦, 是松聖悟, 中野貴司, 宮入烈, 尾内一信, 相澤悠太, 庄司健介, 齋藤昭彦, 森内浩幸, 多屋馨子, 日本小児科学会予防接種・感染症対策委員会

日本小児科学会雑誌 ( (公社)日本小児科学会 ) 127 ( 1 ) 84 - 89 2023.01

国内の地域偏在を調整後に無作為に抽出した小児科1次医療施設100施設、2次医療施設100施設と全ての3次医療施設119施設を候補として、2020年4月(I期)、2020年10月(II期)、2021年4月(III期)の各時点における診療体制についてインターネットを介してアンケート調査した。回答があったのは1次医療施設27施設(回答率27%)、2次医療施設19施設(回答率19%)、3次医療施設72施設(回答率61%)であった。発熱患者の診療応需についてはコロナウイルス感染症2019(COVID-19)接触歴を有する場合、1次医療施設で応需困難となったのはI期で29.6%であったが、II期22.2%、III期14.8%と経時的に減少した。COVID-19患者の診療体制はIII期においても3次医療施設の約半数で軽症・無症状患者の診療が応需されていた。面会制限は大多数の施設で導入され、面会禁止とした施設がIII期においても2次医療施設の63.2%、3次医療施設の38.9%で存在した。

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