The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

Rosenfeld, Nataly; Mandelberg, Avigdor; Dalal, Ilan; Tasher, Diana; Kamar, Alma; Schnapper, Michael; Domany, Keren Armoni

doi:10.1002/ppul.25822

Cited by 3 publications

References 38 publications

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Population Attributable Risk of Wheeze in 2–<6-Year-old Children, Following a Respiratory Syncytial Virus Lower Respiratory Tract Infection in The First 2 Years of Life

Madhi,

Ceballos,

Cousin

et al. 2024

Pediatric Infectious Disease Journal

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Background: There is limited evidence regarding the proportion of wheeze in young children attributable to respiratory syncytial virus lower respiratory tract infections (RSV-LRTI) occurring early in life. This cohort study prospectively determined the population attributable risk (PAR) and risk percent (PAR%) of wheeze in 2–<6-year-old children previously surveilled in a primary study for RSV-LRTI from birth to their second birthday (RSV-LRTI<2Y). Methods: From 2013 to 2021, 2-year-old children from 8 countries were enrolled in this extension study (NCT01995175) and were followed through quarterly surveillance contacts until their sixth birthday for the occurrence of parent-reported wheeze, medically-attended wheeze or recurrent wheeze episodes (≥4 episodes/year). PAR% was calculated as PAR divided by the cumulative incidence of wheeze in all participants. Results: Of 1395 children included in the analyses, 126 had documented RSV-LRTI<2Y. Cumulative incidences were higher for reported (38.1% vs. 13.6%), medically-attended (30.2% vs. 11.8%) and recurrent wheeze outcomes (4.0% vs. 0.6%) in participants with RSV-LRTI<2Y than those without RSV-LRTI<2Y. The PARs for all episodes of reported, medically-attended and recurrent wheeze were 22.2, 16.6 and 3.1 per 1000 children, corresponding to PAR% of 14.1%, 12.3% and 35.9%. In univariate analyses, all 3 wheeze outcomes were strongly associated with RSV-LRTI<2Y (all global P < 0.01). Multivariable modeling for medically-attended wheeze showed a strong association with RSV-LRTI after adjustment for covariates (global P < 0.0001). Conclusions: A substantial amount of wheeze from the second to sixth birthday is potentially attributable to RSV-LRTI<2Y. Prevention of RSV-LRTI<2Y could potentially reduce wheezing episodes in 2–<6-year-old children.

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Population Attributable Risk of Wheeze in 2–<6-Year-old Children, Following a Respiratory Syncytial Virus Lower Respiratory Tract Infection in The First 2 Years of Life

Madhi,

Ceballos,

Cousin

et al. 2024

Pediatric Infectious Disease Journal

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Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Delporte,

Bruwaene,

Bruffaerts

et al. 2024

Preprint

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Purpose: Studies have demonstrated important changes in the seasonality of pediatric respiratory illnesses since the onset of the COVID-19 pandemic. The aim of this study was to describe the epidemiology of childhood wheezing episodes before and after the start of the COVID-19 pandemic in relation to their potentially associated environmental triggers. Methods: Files of all children treated with salbutamol for a wheezing episode in September and October 2019, 2020 and 2021 were retrospectively reviewed. Infection epidemiology, daily concentrations of air pollutants (NO2, O3, PM10 and PM2.5) and fungal spores were collected over the same time period. Results: In 2021, 298 episodes of wheezing were observed compared to 111 in 2020 and 86 in 2019 (p<0.001). Compared to 2019, children with wheezing in 2021 were significantly older (p<0.001), less likely to have a history of recurrent wheezing (p<0.001) and required less hospitalization (p=0.034). Adenovirus and SARS-CoV-2 were more prevalent in 2021 as compared to 2019 (p<0.001). The concentration of PM10, PM2.5 and O3 was higher in 2021, as compared to both 2019 and 2020 (p<0.001) while the concentration of NO2 and airborne spores was lower in 2021 compared to 2019 (p<0.0001). Conclusion: A threefold increase in wheezing episodes was observed in the autumn post-COVID (2021) compared to pre-COVID (2019) together with a significant increase in some viruses and most air pollutants. We hypothesize that this abnormal surge may be related to the release of restrictions with rapid spread of viruses in children who were exposed to high levels of air pollution.

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Impact of reduced COVID-19 restrictions on pediatric recurrent respiratory infections in Southern Italy: a cross-sectional analysis

Indolfi,

Izzo,

Luciano

et al. 2024

Explor Asthma Allergy

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Aim: This study investigated changes in pediatric respiratory health resulting from the easing of COVID-19-related social restrictions, following a noted decrease in respiratory infections during the lockdown. The COVID-19 restrictions have inadvertently influenced the epidemiology of other viruses and contributed to changes in patterns of recurrent respiratory infections (RRIs) in children. Methods: This cross-sectional study analyzed the records of children who underwent at “Respiratory Diseases of Pediatric Interest Unit” at the University Hospital “Luigi Vanvitelli” in Naples, Italy, between October 2022 and June 2023. The study aimed to assess associations with RRIs, the occurrence of febrile episodes, and antibiotic usage. Results: Out of 262 patients (38.2% females, median age 6 years), 81.7% experienced at least one respiratory infection over six months, and 23.7% suffered from RRIs [RRIs in the last six months (RRIS)]. Notably, being underweight was significantly associated with RRIs in the last six months (P-value 0.043), resulting in a 47% increased incidence of respiratory infections (P-value 0.012). No significant associations were observed with sex or age. With increasing age, there was a decreasing incidence rate of 3% for the number of RRIs (P-value 0.019), 4% for febrile episodes (P-value 0.031), and 7% for the number of antibiotic courses (P-value < 0.001). Conclusions: The study emphasizes age and weight’s role in children’s post-COVID-19 RRI prevalence. It signifies the need for proactive preparedness, targeting younger underweight populations and tailored interventions for recurrent cases.

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The impact of the COVID‐19 pandemic on respiratory morbidity during infancy: A birth‐cohort study

Cited by 3 publications

References 38 publications

Population Attributable Risk of Wheeze in 2–<6-Year-old Children, Following a Respiratory Syncytial Virus Lower Respiratory Tract Infection in The First 2 Years of Life

Population Attributable Risk of Wheeze in 2–<6-Year-old Children, Following a Respiratory Syncytial Virus Lower Respiratory Tract Infection in The First 2 Years of Life

Wheezing Episodes in Children Before and After the Onset of the COVID-19 Pandemic in Brussels

Impact of reduced COVID-19 restrictions on pediatric recurrent respiratory infections in Southern Italy: a cross-sectional analysis

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