Severe viral respiratory infections in the pre‐COVID era: A 5‐year experience in two pediatric intensive care units in Italy

Abstract

Background: Viral respiratory infections are one of the main causes of hospitalization in children. Even if mortality rate is low, 2% to 3% of the hospitalized children need mechanical ventilation. Risk factors for admission to the pediatric intensive care unit (PICU) are well known, while few studies have described risk factors for invasive ventilator support and prolonged hospitalization.Methods: A retrospective study including all patients aged between 2 and 18 months with a confirmed viral respiratory infection, requiring admission to PICU from September to March between 2015 and 2019, was conducted at Bambino Gesù Children's Hospital in Rome, Italy.Results: One hundred ninety patients were enrolled, with a median age of 2.7 months; 32.1% had at least one comorbidity, mainly prematurity. The most frequent isolated viruses were RSV-B, rhinovirus, and RSV-A; 38.4% needed mechanical ventilation. This subgroup of patients had lower median birth weight compared with patients not requiring mechanical ventilation (2800 g vs. 3180 g, p = 0.02);

Respiratory syncytial virus: can we still believe that after pandemic bronchiolitis is not a critical issue for public health?

“…In a literature review of 50 articles published between October 1999 and December 2017, RSV has been outlined as the most commonly detected virus (59.2%) as well [ 24 ]. In our cohort, viral coinfection was detected in 24.1% of patients, in agreement with previous studies that describe similar coinfection rates (between 25.8% and 34.7%) [ 25 , 26 ].…”

“…The clinical significance of coinfection remains unclear. Some studies reported increased severity of coinfection, but the impact of coinfection was not particularly obvious in other studies [ 25 , 26 ].…”

Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study

“…Despite being one of the commonest pediatric diseases, uncertainties remain about best diagnostics, treatment strategies and tools to recognize early risk of deterioration. In fact, one of the main challenges that pediatricians face is how to manage a child with a full-blown clinical picture of bronchiolitis but with vital parameters within normal values or borderline, since children with bronchiolitis can deteriorate within hours after initial observation [ 2 ]. While observing these children to monitor progression may be the ideal strategy, this is usually not feasible nor sustainable due to a lack of beds in the observation units and not enough healthcare resources.…”