Influence of the COVID-19 pandemic on the epidemiology of acute bronchiolitis

Barrezueta, Lorena Bermúdez; Zamorano, María Gutiérrez; López-Casillas, Pablo; Brezmes-Raposo, Marta; Fernández, Irene Sanz; Vázquez, María de la Asunción Pino

doi:10.1016/j.eimce.2022.09.001

Cited by 9 publications

(13 citation statements)

References 13 publications

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“…The severity of illness in our cohort was similar to previous epidemics, as has been described in other centers 23,30 . One of the main risk factors for severe bronchiolitis is age, 31 and RSV infections in other countries had been reported to occur in older children during the extemporaneous pandemic season 10 .…”

Section: Discussionsupporting

confidence: 87%

“…A resurgence of bronchiolitis that differed from the usual seasonality was detected worldwide, initially with a reported increase of RSV detections in Australia after restrictions were lifted, 10,22 and followed by delayed peaks of bronchiolitis and other RSV infections in Europe. 11,12,23 The relationship with the trends of COVID-19 transmission are unclear, and although some hypotheses of viral interference have been proposed, more research is needed, 24 but it is evident that the general preventive measures decreased the transmission of most respiratory viruses.…”

Section: Discussionmentioning

confidence: 99%

“…The severity of illness in our cohort was similar to previous epidemics, as has been described in other centers. 23,30 One of the main risk factors for severe bronchiolitis is age, 31 and RSV infections in other countries had been reported to occur in older children during the extemporaneous pandemic season. 10 In our cohort the main burden of hospitalization affected infants between 1 and 3 months, with a median age of 2 months in the pandemic period and 1 month prepandemic, but no statistically significant differences between periods.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, this is the only large single-center study in Spain to have analyzed the epidemic patterns and risk factors for adverse events in the first complete bronchiolitis season after the loosening of pandemic restrictions and make a detailed comparison with research from our group in previous years. 15,17 Other authors have looked at the temporal trends 20 and clinical characteristics in smaller hospitals 9,23,36 until the 2021 summer outbreak. and duration of prophylaxis [42][43][44][45] and to select the ideal timing to conduct clinical trials.…”

Section: Discussionmentioning

confidence: 99%

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Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Guerrero-del-Cueto

Ramos-Fernández

Leiva-Gea

et al. 2023

Pediatric Pulmonology

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Introduction Acute bronchiolitis is the main cause of hospitalization in children under 2 years of age, with a regular seasonality, mostly due to the respiratory syncytial virus. Objectives To describe the epidemiology of bronchiolitis hospitalizations in our center in the last 12 years, and analyze the changes in clinical characteristics, microbiology, and adverse outcomes during the SARS‐CoV‐2 pandemic. Methods Observational study including patients admitted for bronchiolitis between April 2010 and December 2021 in a Spanish tertiary paediatric hospital. Relevant demographic, clinical, microbiological, and adverse outcome variables were collected in an anonymized database. The pandemic period (April 2020 to December 2021) was compared to 2010−2015 seasons using appropriate statistical tests. Results There were 2138 bronchiolitis admissions, with a mean of 195.6 per year between 2010 and 2019 and a 2−4‐month peak between November and March. In the expected season of 2020, there was a 94.4% reduction of bronchiolitis hospitalizations, with only 11 cases admitted in the first year of the pandemic. Bronchiolitis cases increased from the summer of 2021 during a 6‐month long peak, reaching a total of 171 cases. Length of stay was significantly shorter during the pandemic, but no differences were found in clinical and microbiological characteristics or other adverse outcomes. Conclusions The SARS‐CoV‐2 pandemic has modified the seasonality of bronchiolitis hospitalizations, with a dramatic decrease in cases during the expected season of 2020−2021, and an extemporaneous summer−autumn peak in 2021 with longer duration but similar patient characteristics and risk factors.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bronchiolitis before and after the SARS‐CoV‐2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Guerrero-del-Cueto

Ramos-Fernández

Leiva-Gea

et al. 2023

Pediatric Pulmonology

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“…In addition, the period studied was extensive, which allowed for the collection of a non-negligible sample of patients during all seasons of the year and in different epidemic seasons, encompassing diverse viral genotypes throughout the years. Due to the signi cant variation and decrease in respiratory virus circulation observed during the COVID-19 pandemic [32], we restricted the study period to seasons before the onset of the pandemic. Limitations include the single-center and retrospective nature of the study, as well as the lack of quantitative molecular techniques, which did not allow us to know the activity of the viruses at the time of detection.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Viral Coinfections in Infants Hospitalized for Acute Bronchiolitis

Bermúdez-Barrezueta

López-Casillas

Rojo-Rello

et al. 2023

Preprint

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Background and Objective: The clinical relevance of the detection of multiple respiratory viruses in acute bronchiolitis (AB) is not established. Our goal was to evaluate the effect of viral coinfections on the evolution and severity of AB. Methods: A retrospective observational study was conducted in a tertiary hospital in Spain, from September 2012 to March 2020. Infants admitted for AB, with at least one respiratory virus identified by molecular diagnostic techniques were involved. A comparison was made between single virus infection vs viral coinfections. The evolution and severity of AB were determined based on the days of hospitalization and admission to the Pediatric Intensive Care Unit (PICU). Results: Four hundred forty-five patients were included (58.4% male). Median weight was 5.2 kg (RIQ 4.2 – 6.5) and age 2.5 months (RIQ 1.4 – 4.6). A total of 105 patients (23.6%) were admitted to PICU. The Respiratory Syncytial virus (RSV) was the most frequent etiological agent (77.1%). A single virus was detected in 270 patients (60.7%) and viral coinfections in 175 (39.3%), of which 126 (28.3%) had two viruses and 49 (11%) had three or more viruses. Hospital length of stay (LOS) increased proportionally to the number of viruses detected, with a median of 6 days (IQR 4 – 8) in single infection, 7 days (IQR 4 – 9) in coinfection by two viruses and 8 days (IQR 5 – 11) in coinfection ≥ 3 viruses, (p=0.003). The adjusted Cox regression model showed that detection of ≥ 3 viruses was an independent risk factor for longer hospital LOS (HR 0.568, 95%CI 0.410 – 0.785). No significant association was observed between viral coinfections and the need for PICU admission (OR 1.151; 95%CI 0.737 – 1.797). Conclusions: Viral coinfections modify the natural history of AB prolonging the hospital LOS, proportionally to the number of viruses detected, without increasing the need for admission to the PICU.

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