The Association between Weather Conditions and Admissions to the Paediatric Intensive Care Unit for Respiratory Syncytial Virus Bronchiolitis

Abstract

Respiratory syncytial virus (RSV) bronchiolitis is a leading cause of global child morbidity and mortality. Every year, seasonal RSV outbreaks put high pressure on paediatric intensive care units (PICUs) worldwide, including in the Netherlands, and this burden appears to be increasing. Weather conditions have a strong influence on RSV activity, and climate change has been proposed as a potential important determinant of future RSV-related health care utilisation. In this national study spanning a total of 13 years with 2161 PICU admissions for RSV bronchiolitis, we aimed (1) to identify meteorological variables that were associated with the number of PICU admissions for RSV bronchiolitis in the Netherlands and (2) to determine if longitudinal changes in these variables occurred over time as a possible explanation for the observed increase in PICU burden. Poisson regression modelling was used to identify weather variables (aggregated in months and weeks) that predicted PICU admissions, and linear regression analysis was used to assess changes in the weather over time. Maximum temperature and global radiation best predicted PICU admissions, with global radiation showing the most stable strength of effect in both month and week data. However, we did not observe a significant change in these weather variables over the 13-year time period. Based on our study, we could not identify changing weather conditions as a potential contributing factor to the increased RSV-related PICU burden in the Netherlands.

First systematic review and meta-analysis of the risk magnitude of climate-change effects on child health

“…However, variation in diurnal temperature range did not affect the risk of in uenza A virus 101 or childhood pneumonia 106 . Likewise, weather conditions did not affect the risk of paediatric intensive care unit admission due to respiratory syncytial virus infection 107 .…”

The burden of viral infections in pediatric intensive care unit between endemic and pandemic coronavirus infections: A tertiary care center experience

“…Whether these prevalence variations are due to geographic locations and subsequent differences in weather or to the potential consequences of global climate change with variable location impacts is unclear. For instance, a longitudinal investigation in the Netherlands showed that the temperature and global radiation were the most frequently associated weather predictors for disease severity and PICU admissions among children with respiratory viruses [ 18 ]. These factors could partially explain the viral respiratory disease seasonal variations.…”

“…These factors could partially explain the viral respiratory disease seasonal variations. However, these factors do not explain the changing annual prevalence in the same location, as these weather factors remain essentially unchanged locally [ 18 ]. By contrast, the potential change in clinical practices, and enhanced utilization of viral diagnostics could be other possible explanations for the increasing detection in developed countries [ [19] , [20] , [21] ].…”

Impact of COVID-19 on Respiratory Admissions in a Tertiary Pediatric Intensive Care Unit

“…The majority of children in the United States who have been infected with the SARS-CoV-2 virus only experienced a mild illness that did not require hospitalization [ 9 ]. Generally, viral lower respiratory tract infections have a seasonal pattern, resulting in many PICU admissions worldwide, primarily during the winter months [ 10 ]. In late summer 2020, there was concern among the intensivists that there would be an increased burden on the children’s hospitals during the winter months due to the overlap of COVID-19 and seasonal viruses.…”