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The Changing Virology and Trends in Resource Utilization for Bronchiolitis since COVID-19
  • Mary Orr,
  • Allison Burks,
  • William King
Mary Orr
The University of Alabama at Birmingham Department of Pediatrics

Corresponding Author:[email protected]

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Allison Burks
The University of Alabama at Birmingham Department of Pediatrics
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William King
The University of Alabama at Birmingham Department of Pediatrics
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Abstract

Background: Bronchiolitis is a viral respiratory illness most commonly caused by respiratory syncytial virus (RSV). COVID-19 disrupted typical patterns of viral transmission. Our study aimed to compare low value care for bronchiolitis in a tertiary emergency department (ED) in the United States over the previous five years. Methods: This was a descriptive cohort study through a retrospective chart review from 2017-2022 analyzing ED visits for bronchiolitis including disposition, disease severity, chest radiographs, albuterol, and high flow nasal cannula. A year was a 12 month period from March to February. Results: In the three years prior to the pandemic, there were over 2000 ED visits for bronchiolitis per year (3.1% of all ED visits), which decreased to 450 visits for bronchiolitis (1% of all visits) in 2020. Human rhino/enterovirus was the most common virus detected (92%). Admission rates, albuterol use, high flow nasal cannula use, and chest radiographs were all higher during the first year of the pandemic. The summer of 2021 had the highest visits across the 5 study years (2743, 4.0% of all visits) with a return to previous rates of resource utilization. Conclusions: During the early pandemic, measures to halt the spread of COVID-19 also altered the transmission of RSV and emergency visits for bronchiolitis. There was an increase in lower value care while the volume was low and rhinovirus was the dominant virus detected. As restrictions lifted in 2021, there was a large resurgence of RSV in the atypical summer months with a return of previous rates of resource utilization.
07 Jun 2023Submitted to Pediatric Pulmonology
07 Jun 2023Submission Checks Completed
07 Jun 2023Assigned to Editor
07 Jun 2023Review(s) Completed, Editorial Evaluation Pending
13 Jun 2023Reviewer(s) Assigned
20 Jun 2023Editorial Decision: Revise Major
11 Jul 20231st Revision Received
11 Jul 2023Submission Checks Completed
11 Jul 2023Review(s) Completed, Editorial Evaluation Pending
11 Jul 2023Assigned to Editor
11 Jul 2023Reviewer(s) Assigned
15 Jul 2023Editorial Decision: Revise Minor
31 Jul 20232nd Revision Received
31 Jul 2023Assigned to Editor
31 Jul 2023Submission Checks Completed
31 Jul 2023Review(s) Completed, Editorial Evaluation Pending
31 Jul 2023Reviewer(s) Assigned
05 Aug 2023Editorial Decision: Accept