Clinical epidemiology and disease burden of bronchiolitis in hospitalized children in China: a national cross-sectional study

Abstract

Background Bronchiolitis is a common acute lower respiratory tract infection (ALRTI) and the most frequent cause of hospitalization of infants and young children with ALRTI. Respiratory syncytial virus is the main pathogen that leads to severe bronchiolitis. The disease burden is relatively high. To date, few descriptions of the clinical epidemiology and disease burden of children hospitalized for bronchiolitis are available. This study reports the general clinical epidemiological characteristics and disease burden of bronchiolitis in hospitalized children in China. Methods This study included the face sheet of discharge medical records collected from 27 tertiary children’s hospitals from January 2016 to December 2020 that were aggregated into the FUTang Update medical REcords (FUTURE) database. The sociodemographic variables, length of stay (LOS) and disease burden of children with bronchiolitis were analyzed and compared using appropriate statistical tests. Results In total, 42,928 children aged 0–3 years were hospitalized due to bronchiolitis from January 2016 to December 2020, accounting for 1.5% of the total number of hospitalized children of the same age in the database during the period and 5.31% of the hospitalizations for ALRTI. The male to female ratio was 2.01:1. Meanwhile, more boys than girls were observed in different regions, age groups, years, and residences. The 1–2 year age group had the greatest number of hospitalizations for bronchiolitis, while the 29 days–6 months group had the largest proportion of the total inpatients and inpatients with ALRTI in the same age group. In terms of region, the hospitalization rate of bronchiolitis was the highest in East China. Overall, the number of hospitalizations from 2017 to 2020 showed a decreasing trend from that in 2016. Seasonally, the peak hospitalizations for bronchiolitis occurred in winter. Hospitalization rates in North China in autumn and winter were higher than those in South China, while hospitalization rates in South China were higher in spring and summer. Approximately, half of the patients with bronchiolitis had no complications. Among the complications, myocardial injury, abnormal liver function and diarrhea were more common. The median LOS was 6 days [interquartile range (IQR) = 5–8], and the median hospitalization cost was 758 United States dollars (IQR = 601.96–1029.53). Conclusions Bronchiolitis is a common respiratory disease in infants and young children in China, and it accounts for a higher proportion of both total hospitalizations and hospitalizations due to ALRTI in children. Among them, children aged 29 days–2 years are the main hospitalized population, and the hospitalization rate of boys is significantly higher than that of girls. The peak season for bronchiolitis is winter. Bronchiolitis causes few complications and has a low mortality rate, but the burden of this disease is heavy. Supplementary Information ...

Expert consensus on the diagnosis, treatment, and prevention of respiratory syncytial virus infections in children

“…The clinical manifestations of RSV infections in children widely vary in severity according to age. Infants and young children are usually severely affected by potentially life-threatening LRTIs manifesting as bronchiolitis and/or pneumonia, whereas older children typically exhibit mild upper respiratory tract infections [ 25 – 27 ]. When diagnosing bronchiolitis, it should be taken into account that symptoms usually peak 2 to 4 days after onset, during which time symptoms of upper respiratory infections (e.g., fever, nasal congestion, runny nose) subside but manifestations such as shortness of breath, nasal swelling, intercostal or supraclavicular contractures, use of accessory respiratory muscles, and grunts are incredibly exacerbated [ 28 ].…”

Clinical epidemiology and disease burden of adenoviral encephalitis in hospitalized children in China: A nationwide cross‐sectional study

“…Beijing Children's Hospital Affiliated with Capital Medical University has undertaken an initiative to collect the FSMRs of inpatient children from 27 tertiary children's hospitals, creating the Futang Update Medical Records (FUTURE) database 15 . This database has been leveraged to publish numerous studies on diverse illnesses that affect children 10,16–19 . In this particular study, the FSMR details of children admitted with adenovirus encephalitis from the FUTURE database were gathered and organized.…”

“… 15 This database has been leveraged to publish numerous studies on diverse illnesses that affect children. 10 , 16 , 17 , 18 , 19 In this particular study, the FSMR details of children admitted with adenovirus encephalitis from the FUTURE database were gathered and organized.…”

Understanding the uptake and adaption of targeted implementation interventions for reducing bronchiolitis investigations and therapies

“…Bronchiolitis is the leading cause of hospitalisation in infants worldwide. 1 Despite evidence-based guidelines recommending that common investigations and/or therapies are unnecessary, (e.g. chest X-rays (CXR), administration of salbutamol, adrenaline, corticosteroids and antibiotics), it is well documented that these are overused and potentially harmful.…”

“…Bronchiolitis is the leading cause of hospitalisation in infants worldwide 1 . Despite evidence‐based guidelines recommending that common investigations and/or therapies are unnecessary, (e.g.…”