Consequences of COVID-19 pandemic over acute bronchiolitis hospitalizations in the center and east of Spain

Abstract

Introduction Non-pharmaceutical interventions that have been implemented in southern hemisphere countries because of COVID-19 pandemic declaration in March 2020, have evidenced some unexpected changes in the way of spreading of many other viruses. This study as a part of ECEALHBA’s Project, reports the consequences of COVID-19 pandemic over 2020–2021 bronchiolitis epidemic period in the Central and Eastern regions of Spain. Method Multicenter, observational, descriptive and ambispective study of admitted infants with the diagnosis of bronchiolitis in 16 Spanish hospitals involved in the investigation project. Five epidemic periods previous to COVID-19 pandemic, from 2015 to 2020, were compared with the current one, 2020–2021, in both a qualitative and quantitative manner. Results Total of 4643 infants were admitted to the participating hospitals along the study period. Pandemic season hospital admissions for bronchiolitis were 94.1% lower than in pre-pandemic period. December and January were peak months for bronchiolitis admissions during pre-pandemic period, but September was the peak month during pandemic year. There was a progressive decrease of admissions from this moment until the end of the follow-up, in April 2021. Rhinovirus has been the commonest etiology for bronchiolitis in 2020–2021 epidemic period of bronchiolitis. Conclusions Some of the non-pharmaceutical interventions initiated because of COVID-19 pandemic are probably related to the dramatic decrease of bronchiolitis cases in 2020–2021 season. It would be rewarding to purpose novel research to clarify how these simple interventions can be useful, close to vaccines and antiviral drugs, to achieve the goal of avoiding the spread of respiratory viruses in pediatric population.

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

“…Similarly, this study found that about 50% of the hospitalized children born in 2021 were born in September or October, at the beginning of the RSV epidemic. The length of hospital stay in the present study was nearly 6 days, longer than the 4.4 days reported in Spain and the 2.1 days reported in Australia [ 40 , 45 ]. The extended length of stay in the present study may be due to the younger age of the children hospitalized in Italy.…”

“…During the COVID-19 pandemic in the 2020–2021 season, rhinovirus was reported to be primarily responsible for acute respiratory syndrome and hospitalizations for bronchiolitis [ 31 , 33 , 45 ]. This non-enveloped virus is less affected by NPIs, such as handwashing and the use of ethanol-containing disinfectants [ 46 , 47 ].…”

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

“…Although some authors have speculated on the appearance of a delayed outbreak of AB in Spain during the COVID-19 pandemic 7 , 8 , to our knowledge, this is the first study to describe this particular epidemiological phenomenon, providing results about the seasonal behaviour of different respiratory viruses over several seasons in an area of Spain. It would be of great interest to continue to have similar and broader records in the coming years.…”

“…Every year, when winter arrives, respiratory virus infections increase and cases of AB rise to epidemic levels, creating a significant demand for healthcare with a risk of saturating the health system and having a significant socioeconomic impact. However, during the 2020-2021 autumn-winter season, this disease was practically non-existent in Spain and other countries 3 , 5 , 7 , 8 , 9 , 10 , 11 , 12 .…”

“…In relation to this epidemiological change, most authors agree that the measures applied to control the transmission of SARS-CoV-2, such as hand hygiene, the use of face covering and social distancing, contributed to reducing the circulation of other respiratory viruses 2 , 4 , 8 , 12 . The temporal relationship between the relaxation of social restrictions in Spain in May 2021 and the re-emergence of respiratory viruses such as RSV would appear to support this hypothesis.…”