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How has the SARS-CoV-2 pandemic changed the epidemiology and management of acute bronchiolitis?
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  • Giacomo Brisca,
  • Marcello Mariani,
  • Silvia Buratti,
  • Marta Ferretti,
  • Daniela Pirlo,
  • Isabella Buffoni,
  • Marisa Mallamaci,
  • Pietro Salvati,
  • Giulia Tagliarini,
  • Emanuela Piccotti,
  • Oliviero Sacco,
  • Elio Castagnola,
  • Andrea Moscatelli
Giacomo Brisca
Istituto Giannina Gaslini

Corresponding Author:[email protected]

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Marcello Mariani
Istituto Giannina Gaslini
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Silvia Buratti
Istituto Giannina Gaslini
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Marta Ferretti
Istituto Giannina Gaslini
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Daniela Pirlo
Istituto Giannina Gaslini
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Isabella Buffoni
Istituto Giannina Gaslini
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Marisa Mallamaci
Istituto Giannina Gaslini
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Pietro Salvati
Istituto Giannina Gaslini
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Giulia Tagliarini
Universita degli Studi di Genova Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili
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Emanuela Piccotti
Istituto Giannina Gaslini
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Oliviero Sacco
Istituto Giannina Gaslini
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Elio Castagnola
Istituto Giannina Gaslini
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Andrea Moscatelli
Istituto Giannina Gaslini
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Abstract

Objective: SARS-COV-2 pandemic had a profound impact on acute bronchiolitis epidemiology, especially in RSV diffusion and the burden of disease with implications on the management of prophylaxis and health resources. We aimed to compare clinical and epidemiological characteristics of bronchiolitis before and during the SARS-CoV-2 pandemic.   Methods: We conducted an observational study involving children aged 0-2 years with bronchiolitis admitted to a tertiary children’s hospital during the last 5 years. Demographic, clinical, microbiological, and outcome data were collected. Comparison between pre- and post-pandemic period, RSV positive versus non-RSV patients, and SARS-CoV-2 positive vs negative patients were carried out.    Results: A total of 647 patients admitted for bronchiolitis were included (264 female,40.8%, median age 78 days). Molecular diagnostic tests were performed in 617 patients (95.4%) with RSV detected in 62.5% of patients. SARS-CoV-2 was found in 3.9% of hospitalized bronchiolitis (3.9%). We observed a progressive increase in bronchiolitis admissions and a statistically significant increase over the years in the need for respiratory support. Conversely, this was not true for mechanical ventilation, duration of respiratory support, ICU admission, and length of stay. During the pandemic period children with prematurity increased, although only 1 child had an indication for prophylaxis. Discussion: We confirm the stronger impact of bronchiolitis in the 2021-22 season, which is likely explained by the higher prevalence of RSV and the immunity debt theory. However, our findings were conflicting in terms of worsening clinical severity. The increase of children with prematurity and the inter-seasonal spread of RSV highlight the importance of epidemiological surveillance systems that monitor RSV circulation.
20 Oct 2022Submitted to Pediatric Pulmonology
20 Oct 2022Submission Checks Completed
20 Oct 2022Assigned to Editor
20 Oct 2022Review(s) Completed, Editorial Evaluation Pending
31 Oct 2022Reviewer(s) Assigned
08 Nov 2022Editorial Decision: Revise Major
23 Nov 20221st Revision Received
23 Nov 2022Assigned to Editor
23 Nov 2022Submission Checks Completed
23 Nov 2022Review(s) Completed, Editorial Evaluation Pending
23 Nov 2022Reviewer(s) Assigned
09 Dec 2022Editorial Decision: Revise Minor
27 Dec 20222nd Revision Received
30 Dec 2022Submission Checks Completed
30 Dec 2022Assigned to Editor
30 Dec 2022Review(s) Completed, Editorial Evaluation Pending
30 Dec 2022Reviewer(s) Assigned
12 Jan 2023Editorial Decision: Accept