Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

Cozzi, Giorgio; Wiel, Luisa Cortellazzo; Amaddeo, Alessandro; Gatto, Antonio; Giangreco, Manuela; Klein-Kremer, Adi; Bosis, Samantha; Silvagni, Davide; Debbia, Carla; Nanni, Laura; Chiappa, S; Minute, Marta; Corsini, Ilaria; Morabito, Giuliana; Gortan, Anna Jolanda; Colombo, Marco; Marchetti, Federico; Garelli, Davide; Piffer, Arianna; Cardinale, Fabio; Levy, Nitai; Curatola, Antonietta; Gojsina, Bojana; Basu, Suvradeep; Barbi, Egidio; Sovtić, Aleksandar

doi:10.1136/archdischild-2021-323559

Cited by 13 publications

(30 citation statements)

References 31 publications

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“…The most frequent symptom was fever, followed by respiratory symptoms, such as a cough and mild breathing difficulties, as previously reported 3 . None of the virus positive infants developed bronchiolitis, in line with other data 4 . In fact, infants in the virus negative group were more likely to need intensive care for bronchiolitis and the respiratory syncytial virus, despite the dramatic decreases in these during the first year of the pandemic 5 …”

Section: Positive For Sars‐cov‐2 (N = 29) Negative For Sars‐cov‐2 (N ...supporting

confidence: 88%

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Mild COVID‐19 in hospitalised infants younger than 90 days

et al. 2022

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Clinical manifestations of COVID-19 are generally milder in children than adults. Severe acute respiratory distress syndrome is rarely reported, even though cardiovascular diseases, diabetes and chronic lung diseases have been associated with severe outcomes. 1 Children Other 36 (26%) Abbreviations: NICU, neonatal intensive care unit; OBI, brief intensive observation; PICU, paediatric intensive care unit; PED, paediatric emergency department. a Respiratory support: oxygen, high-flow nasal cannula, continuous positive airway pressure.

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Section: Positive For Sars‐cov‐2 (N = 29) Negative For Sars‐cov‐2 (N ...supporting

confidence: 88%

“…3 None of the virus positive infants developed bronchiolitis, in line with other data. 4 In fact, infants in the virus negative group were more likely to need intensive care for bronchiolitis and the respiratory syncytial virus, despite the dramatic decreases in these during the first year of the pandemic. 5 Our study had some limitations.…”

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Mild COVID‐19 in hospitalised infants younger than 90 days

et al. 2022

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“…Despite the limitations, these data showed that, in children under two years of age with SARS-CoV-2 infection, respiratory symptoms are less severe compared to those observed in children with RSV infection or co-infection; in addition, SARS-CoV-2 infection is confirmed to be a less common cause of bronchiolitis compared to SARS-CoV-2. Surprisingly, despite what reported in the literature [ 7 ] our data showed that SARS-CoV-2 bronchiolitis is not mild. Our cohort of children with SARS-CoV-2-induced bronchiolitis showed a similar risk of a severe clinical course compared to children with bronchiolitis induced by RSV and co-infections.…”

Section: Discussioncontrasting

confidence: 99%

“…In our population, bronchiolitis was more frequently observed in the group of children with RSV infection 68/78 (87.1%) than in children with co-infection 9/13 (69.2%) or children with SARS-CoV-2 infection alone 10/47 (21.3%). This result agrees with data from the literature showing that bronchiolitis due to SARS-CoV-2 is less frequently observed than RSV-induced bronchiolitis is [ 7 ]. Despite this, the incidence in our population is still higher than that reported in the literature, also because the infections of our cohort originate from the Omicron rather than the Delta variant wave.…”

Section: Discussionsupporting

confidence: 92%

“…Widely implemented non-pharmaceutical interventions (NPIs) against SARS-CoV-2—e.g., stay-at-home orders, the wearing of face coverings, physical distancing, and the promotion of improved hygiene, such as hand washing—all have the potential to prevent the transmission of other communicable (particularly respiratory) diseases. During the SARS-CoV-2 pandemic, a marked decrease in the number of bronchiolitis cases and the disappearance of the RSV winter epidemic were observed, and SARS-CoV-2-related bronchiolitis, although rare, with a mild clinical course, was observed [ 7 ]. A significant effect on respiratory and non-respiratory admissions, particularly with decreases in hospital admissions of respiratory infections, was observed with a steep reduction in all RSV indicators, fewer laboratory-confirmed cases, fewer hospital admissions, and fewer instances of emergency department access by children younger than 5 years of age during the pandemic [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Presentation and Severity of SARS-CoV-2 Infection Compared to Respiratory Syncytial Virus and Other Viral Respiratory Infections in Children Less than Two Years of Age

Nunziata

Salomone

Catzola³

et al. 2023

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The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the implementation of restrictive measures led to a dramatic reduction in respiratory syncytial virus (RSV) occurrence together with rare and mild bronchiolitis induced by SARS-CoV-2. We described the respiratory picture of SARS-CoV-2 infection and evaluated the frequency and the severity of SARS-CoV-2 bronchiolitis comparing it with other respiratory viral infections in children less than two years of age. The severity of respiratory involvement was evaluated based on the need for oxygen therapy, intravenous hydration, and the length of hospital stay. A total of 138 children hospitalized for respiratory symptoms were enrolled: 60 with SARS-CoV-2 and 78 with RSV. In the group of SARS-CoV-2-infected children, 13/60 (21%) received a diagnosis of co-infection. Among the enrolled children, 87/138 (63%) received a diagnosis of bronchiolitis. The comparative evaluation showed a higher risk of the need for oxygen therapy and intravenous hydration in children with RSV infection and co-infection compared to children with SARS-CoV-2 infection. In the children with a diagnosis of bronchiolitis, no differences in the main outcomes among the groups were observed. Although children with SARS-CoV-2 infection have less severe respiratory effects than adults, the pediatrician should pay attention to bronchiolitis due to SARS-CoV-2, which could have a severe clinical course in younger children.

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Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2

et al. 2023

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ImportanceThe prevalence of urinary tract infection (UTI), bacteremia, and bacterial meningitis in febrile infants with SARS-CoV-2 is largely unknown. Knowledge of the prevalence of these bacterial infections among febrile infants with SARS-CoV-2 can inform clinical decision-making.ObjectiveTo describe the prevalence of UTI, bacteremia, and bacterial meningitis among febrile infants aged 8 to 60 days with SARS-CoV-2 vs without SARS-CoV-2.Design, Setting, and ParticipantsThis multicenter cross-sectional study was conducted as part of a quality improvement initiative at 106 hospitals in the US and Canada. Participants included full-term, previously healthy, well-appearing infants aged 8 to 60 days without bronchiolitis and with a temperature of at least 38 °C who underwent SARS-CoV-2 testing in the emergency department or hospital between November 1, 2020, and October 31, 2022. Statistical analysis was performed from September 2022 to March 2023.ExposuresSARS-CoV-2 positivity and, for SARS-CoV-2–positive infants, the presence of normal vs abnormal inflammatory marker (IM) levels.Main Outcomes and MeasuresOutcomes were ascertained by medical record review and included the prevalence of UTI, bacteremia without meningitis, and bacterial meningitis. The proportion of infants who were SARS-CoV-2 positive vs negative was calculated for each infection type, and stratified by age group and normal vs abnormal IMs.ResultsAmong 14 402 febrile infants with SARS-CoV-2 testing, 8413 (58.4%) were aged 29 to 60 days; 8143 (56.5%) were male; and 3753 (26.1%) tested positive. Compared with infants who tested negative, a lower proportion of infants who tested positive for SARS-CoV-2 had UTI (0.8% [95% CI, 0.5%-1.1%]) vs 7.6% [95% CI, 7.1%-8.1%]), bacteremia without meningitis (0.2% [95% CI, 0.1%-0.3%] vs 2.1% [95% CI, 1.8%-2.4%]), and bacterial meningitis (&lt;0.1% [95% CI, 0%-0.2%] vs 0.5% [95% CI, 0.4%-0.6%]). Among infants aged 29 to 60 days who tested positive for SARS-CoV-2, 0.4% (95% CI, 0.2%-0.7%) had UTI, less than 0.1% (95% CI, 0%-0.2%) had bacteremia, and less than 0.1% (95% CI, 0%-0.1%) had meningitis. Among SARS-CoV-2–positive infants, a lower proportion of those with normal IMs had bacteremia and/or bacterial meningitis compared with those with abnormal IMs (&lt;0.1% [0%-0.2%] vs 1.8% [0.6%-3.1%]).Conclusions and RelevanceThe prevalence of UTI, bacteremia, and bacterial meningitis was lower for febrile infants who tested positive for SARS-CoV-2, particularly infants aged 29 to 60 days and those with normal IMs. These findings may help inform management of certain febrile infants who test positive for SARS-CoV-2.

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Prevalence of SARS-CoV-2 positivity in infants with bronchiolitis: a multicentre international study

Cited by 13 publications

References 31 publications

Mild COVID‐19 in hospitalised infants younger than 90 days

Mild COVID‐19 in hospitalised infants younger than 90 days

Clinical Presentation and Severity of SARS-CoV-2 Infection Compared to Respiratory Syncytial Virus and Other Viral Respiratory Infections in Children Less than Two Years of Age

Prevalence of Urinary Tract Infection, Bacteremia, and Meningitis Among Febrile Infants Aged 8 to 60 Days With SARS-CoV-2

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