The acute bronchiolitis rebound in children after COVID-19 restrictions: a retrospective, observational analysis
Keywords:
Bronchiolitis, COVID-19, Pediatric Emergency Department, Respiratory Syncytial Virus, SARS-CoV-2Abstract
Background and aim: Bronchiolitis represents the main cause of illness and hospitalization in infants and young children. The aim of this study was to compare the Pediatric Emergency Department (PED) admissions for bronchiolitis during the post-COVID (Coronavirus disease) period to those of previous seasons and to analyze their etiology during COVID and post-COVID period. Methods: We compared demographics, clinical and microbiological data of children admitted to PED with bronchiolitis between September 2021 and March 2022 (post-COVID period) to the previous seasons (COVID and pre-COVID period). Results: During the post-COVID period the bronchiolitis season started earlier than usual, with a peak reached in November 2021; a gradual reduction was subsequently observed between December 2021 and January 2022. Our data showed a prevalence of High Priority code in children admitted to the PED with bronchiolitis during the post-COVID period (61.4%) compared the pre-COVID period (34.8%) (p=0.00). Also regarding the hospitalization of these patients, we found a major rate of hospitalization during this epidemic season (p=0.035). In addition, only 4 (1.5%) of the tested children resulted positive for SARS-CoV-2 and all of them were admitted to PED during the post-COVID period. The search for the other respiratory viruses showed during the current season a prevalence of respiratory syncytial virus (RSV) (60.2%), followed by Human Rhinovirus (30.1%). Conclusions: The post-COVID period was characterized by an early and short-term peak in acute bronchiolitis, with an increased rate of hospitalization. In addition, SARS-CoV-2 infection was rarely cause of bronchiolitis in children under 2 years old.
References
Shi T, McAllister DA, O’Brien KL, et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study. The Lancet. 2017, 390:946–58.
Ralston SL, Lieberthal AS, Meissner HC, et al. Clinical Practice Guideline: The Diagnosis, Management, and Prevention of Bronchiolitis. Pediatrics. 2014, 134:e1474–502.
Tregoning JS, Schwarze J. Respiratory Viral Infections in Infants: Causes, Clinical Symptoms, Virology, and Immunology. Clin Microbiol Rev. 2010, 23:74–98.
Nair H, Nokes DJ, Gessner BD, et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. The Lancet. 2010, 375:1545–55.
Reeves RM, Hardelid P, Gilbert R, et al. Estimating the burden of respiratory syncytial virus (RSV) on respiratory hospital admissions in children less than five years of age in England, 2007-2012. Influenza Other Respi Viruses. 2017, 11:122–9.
Miller EK, Gebretsadik T, Carroll KN, et al. Viral Etiologies of Infant Bronchiolitis, Croup and Upper Respiratory Illness During 4 Consecutive Years. Pediatric Infectious Disease Journal. 2013, 32:950–5.
Fricke LM, Glöckner S, Dreier M, et al. Impact of non-pharmaceutical interventions targeted at COVID-19 pandemic on influenza burden – a systematic review. Journal of Infection. 2021, 82:1–35.
Curatola A, Lazzareschi I, Bersani G, et al. Impact of COVID‐19 outbreak in acute bronchiolitis: Lesson from a tertiary Italian Emergency Department. Pediatric Pulmonology. 2021, 56:2484–8.
Rotulo GA, Percivale B, Molteni M, et al. The impact of COVID-19 lockdown on infectious diseases epidemiology: The experience of a tertiary Italian Pediatric Emergency Department. The American Journal of Emergency Medicine. 2021, 43:115–7.
Cohen R, Ashman M, Taha M-K, et al. Pediatric Infectious Disease Group (GPIP) position paper on the immune debt of the COVID-19 pandemic in childhood, how can we fill the immunity gap? Infectious Diseases Now. 2021, 51:418–23.
Guedj R, Lorrot M, Lecarpentier T,et al. Infant bronchiolitis dramatically reduced during the second French COVID‐19 outbreak. Acta Paediatr. 2021, 110:1297–9.
Van Brusselen D, De Troeyer K, ter Haar E, et al. Bronchiolitis in COVID-19 times: a nearly absent disease? Eur J Pediatr. 2021, 180:1969–73.
Cowling BJ, Ali ST, Ng TWY, et al. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. The Lancet Public Health. 2020, 5:e279–88.
Leung NHL, Chu DKW, Shiu EYC, et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med. 2020, 26:676–80.
Baker RE, Park SW, Yang W, et al. The impact of COVID-19 nonpharmaceutical interventions on the future dynamics of endemic infections. Proc Natl Acad Sci USA. 2020, 117:30547–53.
Delestrain C, Danis K, Hau I, et al. Impact of COVID‐19 social distancing on viral infection in France: A delayed outbreak of RSV. Pediatric Pulmonology. 2021, 56:3669–73.
Azzari, C., Baraldi, E., Bonanni, P., et al. Epidemiology and prevention of respiratory syncytial virus infections in children in Italy. Italian journal of pediatrics. 2021, 47(1), 198
Chu HY, Kuypers J, Renaud C, et al. Molecular epidemiology of respiratory syncytial virus transmission in childcare. Journal of Clinical Virology. 2013, 57:343–50.
Reis J, Shaman J. Retrospective Parameter Estimation and Forecast of Respiratory Syncytial Virus in the United States. Wilke CO, ed. PLoS Comput Biol. 2016, 12:e1005133.
Rahman B, Sadraddin E, Porreca A. The basic reproduction number of SARS‐CoV‐2 in Wuhan is about to die out, how about the rest of the World? Rev Med Virol. 2020, 30. Available from: https://onlinelibrary.wiley.com/doi/10.1002/rmv.2111
Bozzola E, Ciarlitto C, Guolo S, et al. Respiratory Syncytial Virus Bronchiolitis in Infancy: The Acute Hospitalization Cost. Front Pediatr. 2021, 8:594898.
Cozzi G, Cortellazzo Wiel L, Amaddeo A, et al. Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study. Arch Dis Child. 2022; archdischild-2021-323559.
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Copyright (c) 2023 Antonietta Curatola, Benedetta Graglia, Serena Ferretti, Marcello Covino, Valeria Pansini, Gemma Eftimiadi, Antonio Chiaretti, Antonio Gatto
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