Bronchiolitis, epidemiological changes during the SARS-CoV-2 pandemic

Abstract

Background Bronchiolitis is the most common viral infection of the lower respiratory tract in infants under 2 years of age. The aim of this study was to analyze and compare the seasonal bronchiolitis peaks before and during the SARS-CoV-2 pandemic. Methods Descriptive, prospective, and observational study. Patients with severe bronchiolitis admitted to the Pediatric Intensive Care Unit (PICU) of a referral tertiary hospital between September 2010 and June 2021 were included. Demographic data were collected. Viral laboratory-confirmation was carried out. Each season was analyzed and compared. The daily average temperature was collected. Results 1116 patients were recruited, 58.2% of them males. The median age was 49 days. Respiratory syncytial virus (RSV) was isolated in 782 cases (70.1%). In April 2021, the first and only case of bronchiolitis caused by SARS-CoV-2 was identified. The pre- and post-pandemic periods were compared. There were statistically significant differences regarding: age, 47 vs. 73 days (p = 0.006), PICU and hospital length of stay (p = 0.024 and p = 0.001, respectively), and etiology (p = 0.031). The peak for bronchiolitis in 2020 was non-existent before week 52. A delayed peak was seen around week 26/2021. The mean temperature during the epidemic peak was 10ºC for the years of the last decade and is 23ºC for the present season. Conclusion The COVID-19 pandemic outbreak has led to a clearly observable epidemiological change regarding acute bronchiolitis, which should be studied in detail. The influence of the environmental temperature does not seem to determine the viral circulation.

An Italian Multicenter Study on the Epidemiology of Respiratory Syncytial Virus During SARS-CoV-2 Pandemic in Hospitalized Children

“…The score included the child’s color, respiratory rate, presence of wheeze, use of accessory muscles, mental status, and oxygen saturation, and each variable ranges from 0 to 2. Thus, CRS total score ranges from 0 to 12 and defines into three categories: Mild (<3), Moderate ( 4 – 7 ), and Severe ( 8 – 12 ) ( 15 ).…”

Out-of-Season Epidemic of Respiratory Syncytial Virus during the COVID-19 Pandemic: The High Burden of Child Hospitalization in an Academic Hospital in Southern Italy in 2021

“…In the last 2 years, public health measures aimed at controlling the spread of SARS-CoV-2, such as stay-at-home orders and social distancing, have altered the epidemiology and seasonality of other respiratory viruses [ 20 , 21 ]. Some studies showed a drastic reduction in the number of hospitalizations and a reduction in the length of hospital stay in children with respiratory diseases [ 22 , 23 ]. Moreover, a drop in the total number of pediatric consultations was reported during the 2020 lockdown both in Italy and in Finland [ 24 , 25 ].…”

“…Also in Finland, a rapid decrease in RSV cases was observed in 2020 [ 25 ]. A study conducted in Spain during the pandemic period revealed a very low burden of bronchiolitis, mostly caused by RSV, and a delayed peak compared with previous years [ 22 ]. In Italy, systematic national surveillance of RSV is lacking, therefore very few epidemiological data are available.…”

Evaluation of reported medical services provided to pediatric viral bronchiolitis diagnoses during the COVID-19 pandemic

“…Children may be less likely to develop critical illness or concerning symptoms (i.e. viral wheeze) from COVID-19 prompting a medical evaluation [21] , [22] , [23] . Finally, the presence of a non-COVID respiratory viral infection may interfere or block infection from other viruses (including COVID-19) [24] .…”