Pediatric respiratory admissions and related viral infections during the COVID‐19 pandemic

Abstract

Introduction:The COVID-19 pandemic has affected the incidence of respiratory viral infections. Our aim was to assess changes in pediatric admissions due to respiratory diseases and associated respiratory viral infections.Methods: An observational study including all respiratory admissions to the pediatric departments from January 2015 to August 2021. We compared respiratory admission percentage, respiratory viral panel results and clinical characteristics of these admissions between two study periods, January 2015 to February 2020 (pre-COVID-19 era) and March 2020 to August 2021 (COVID-19 era).Results: A total of 8774 respiratory admissions were included, 7157 pre-COVID-19 era and 1617 COVID-19 era. Relative to all pediatric admissions, there was a 17% decrease in respiratory admission percentage during the COVID-19 era (p < 0.001) and a 31% and 22% decreased in the admission percentages due to bronchiolitis (p < 0.001) and pneumonia (p < 0.001), respectively. However, admission percentages for asthma, wheezing illness, complicated pneumonia, and stridor remained the same. There was a significant decrease in the detection of a respiratory viral pathogen associated with these respiratory admissions (p < 0.001). This was related to a significant decrease in the detection of respiratory syncytial virus (RSV) (37% vs. 27%, p < 0.001) and influenza (5% vs. 0.3%, p < 0.001), but not other respiratory viruses. An alteration in the circulation pattern of most respiratory viruses, was observed.Conclusions: During the COVID-19 pandemic, a decrease in the prevalence of RSV and influenza was associated with a significant decrease in admissions for bronchiolitis and pediatric pneumonia. This may allow us to estimate the significance of preventive measures for RSV and influenza on pediatric respiratory admissions.

The changing virology and trends in resource utilization for bronchiolitis since COVID‐19

“…An atypical summer spike in RSV in 2021 followed, which is likely the primary driver in the increased bronchiolitis visits, both features seen in other studies. 13,[17][18][19]27 The summer ED visits that year were almost as high as the winter of the last typical season in 2019, though there was a bimodal distribution with an increase in the winter months though lower than the summer surge, suggesting there is still some seasonality During the low volume year of 2020, rhino/enterovirus was the predominant virus detected by percentage, though the raw number detected was relatively similar to previous years. It is possible that more rhinovirus was detected due to higher testing rates, which increased by 23% from the year prior.…”

“…Another study reported no change in admissions for wheezing at this time. 13 The dominance of rhino/enterovirus during the emergence of the pandemic and the disappearance of RSV raises important questions about how the transmission of this virus was affected by efforts to slow the spread of COVID-19. RSV is an enveloped, singlestranded, negative-sense RNA virus of the Pneumoviridae family and is transmitted via droplet.…”

“…10,11 A sharp decline in bronchiolitis was noted worldwide while COVID-19 cases were rising. [11][12][13][14][15][16][17][18][19][20][21] A decrease in RSV cases continued worldwide during the first year of the pandemic in 2020 to early 2021. 4,[12][13][14][15][16][17][18][19][20] Previous studies have focused on all ED visits or just inpatient visits during the pandemic, but there is a lack of information about changing patterns of bronchiolitis ED visits after more recent rebounds, as well as how the changing volumes affect typical Basic database management and analysis of descriptive statistics were performed using Excel and SSPS statistical software.…”

“…[11][12][13][14][15][16][17][18][19][20][21] A decrease in RSV cases continued worldwide during the first year of the pandemic in 2020 to early 2021. 4,[12][13][14][15][16][17][18][19][20] Previous studies have focused on all ED visits or just inpatient visits during the pandemic, but there is a lack of information about changing patterns of bronchiolitis ED visits after more recent rebounds, as well as how the changing volumes affect typical Basic database management and analysis of descriptive statistics were performed using Excel and SSPS statistical software. Comparisons of differences among and within the 5-year study samples were accomplished using the One way analysis of variance with post hoc pairwise multiple year comparisons using Tukey's HSD at alpha = .05.…”

Effects of COVID-19 pandemic–associated reduction in respiratory infections on infantile asthma development

“…During the nearly 3-year-long COVID-19 pandemic, unprecedented attempts have been made worldwide to prevent infection, and both children and adults have been encouraged to wear masks, wash their hands, and keep their distance from others. 1 , 13 In Japan, children in kindergartens and elementary and junior high schools have been forced to limit class hours and change class formats over a long period of time. 14 Thus, it is speculated that these actions significantly reduced the prevalence of respiratory tract infections in children during the pandemic.…”