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

Abstract

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.

Respiratory syncytial virus in children: epidemiology and clinical impact post-COVID-19

“…In Australia, a rapid decline in laboratory-proven RSV episodes and bronchiolitis-coded hospital admissions was observed following implementation of significant NPIs, resulting in the near absence of the 2020 winter season [8 ▪▪ ]. Similar reductions were observed in other countries [9–11] with numerous authors raising concern that a surge in unexpected RSV activity could overwhelm health systems already at capacity [5,8 ▪▪ ,12–15].…”

“…Second to neonatal disorders, RSV is the most common cause of infant mortality responsible for 3.6 million hospital admissions and 26 300 in-hospital deaths, of which 97% occur in lower-middle resource settings [1][2][3]. Yearly winter epidemics of RSV are typically observed in temperate climate areas, with year-round sporadic activity observed in tropical climates [4,5]. The Coronavirus Disease (COVID-19) pandemic significantly impacted on RSV activity in both northern and southern hemispheres [6 transmission disrupted the seasonality of many viruses, including RSV [7].…”

Antibiotic Use in Korean Children Diagnosed With Acute Bronchiolitis: Analysis of the National Health Insurance Reimbursement Data

“…Bacterial infections were identified in about 14% of children with LRIs caused by RSV infection or acute bronchiolitis. 38 39 Therefore, inpatient ASP targeting hospital pediatricians should be reinforced, and tremendous efforts for appropriate antibiotic use are required in pediatricians.…”

Waiting for the next winter. Outpatient pediatric visits for respiratory infections before, during, and after the COVID‐19 pandemic in the city of Buenos Aires

“…However, many of the reports refer to a specific disease (bronchiolitis) or to a particular virus (respiratory syncytial virus [RSV] and influenza), include data from one or a few centers, or refer to hospitalized patients 4–6 . In contrast, there is little information on the magnitude of this phenomenon in larger populations, especially in relation to less seriously affected patients, who tend to be the majority in the case of ALRI.…”