Respiratory Syncytial Virus Bronchiolitis Before and After COVID-19 Pandemic: Has the Immunity Debt Been Paid Off?


Journal

The Pediatric infectious disease journal
ISSN: 1532-0987
Titre abrégé: Pediatr Infect Dis J
Pays: United States
ID NLM: 8701858

Informations de publication

Date de publication:
28 Feb 2024
Historique:
medline: 7 3 2024
pubmed: 7 3 2024
entrez: 7 3 2024
Statut: aheadofprint

Résumé

Our aim was to hypothesize that the COVID-19 pandemic influenced the characteristics of viral bronchiolitis by comparing the last 3 epidemics with 3 pre-COVID-19 epidemics in infants hospitalized with bronchiolitis. We prospectively enrolled 637 consecutive infants (median age 3.0 ± 2.1 months, 58.5% males), hospitalized for bronchiolitis during 6 consecutive annual epidemic seasons from 2017 to 2023. All parents of the children were given a structured anamnestic questionnaire. A nasopharyngeal aspirate was tested for 15 respiratory viruses. As measures of severity, we evaluated the O2 supplementation and the admission at the pediatric intensive care unit. A total of 166 were hospitalized with bronchiolitis in 2017-2018, 97 in 2018-2019, 69 in 2019-2020, 0 in 2020-2021, 129 in 2021-2022 and 176 in 2022-2023. Taking together the 332 bronchiolitis cases hospitalized during the 3 prepandemic seasons, they peaked between December and January; after the flat curve in 2020-2021, the cases of bronchiolitis peaked in November 2021 and in December 2022. While the 2021-2022 season registered a less severe clinical presentation, O2 supplementation and pediatric intensive care unit admissions increased in 2022-2023 with respect to the prepandemic seasons (P < 0.001). This study represents an important scientific demonstration of the impact of primary prevention measures on the epidemiology of viral infections; their fluctuations were related to the intensity of restrictive measures and to the changing trend of respiratory viruses. It is essential to predict the real temporal trend of bronchiolitis in order not to leave high-risk children uncovered and to guide hospitals to maintain a high level of readiness.

Sections du résumé

BACKGROUND BACKGROUND
Our aim was to hypothesize that the COVID-19 pandemic influenced the characteristics of viral bronchiolitis by comparing the last 3 epidemics with 3 pre-COVID-19 epidemics in infants hospitalized with bronchiolitis.
METHODS METHODS
We prospectively enrolled 637 consecutive infants (median age 3.0 ± 2.1 months, 58.5% males), hospitalized for bronchiolitis during 6 consecutive annual epidemic seasons from 2017 to 2023. All parents of the children were given a structured anamnestic questionnaire. A nasopharyngeal aspirate was tested for 15 respiratory viruses. As measures of severity, we evaluated the O2 supplementation and the admission at the pediatric intensive care unit.
RESULTS RESULTS
A total of 166 were hospitalized with bronchiolitis in 2017-2018, 97 in 2018-2019, 69 in 2019-2020, 0 in 2020-2021, 129 in 2021-2022 and 176 in 2022-2023. Taking together the 332 bronchiolitis cases hospitalized during the 3 prepandemic seasons, they peaked between December and January; after the flat curve in 2020-2021, the cases of bronchiolitis peaked in November 2021 and in December 2022. While the 2021-2022 season registered a less severe clinical presentation, O2 supplementation and pediatric intensive care unit admissions increased in 2022-2023 with respect to the prepandemic seasons (P < 0.001).
CONCLUSIONS CONCLUSIONS
This study represents an important scientific demonstration of the impact of primary prevention measures on the epidemiology of viral infections; their fluctuations were related to the intensity of restrictive measures and to the changing trend of respiratory viruses. It is essential to predict the real temporal trend of bronchiolitis in order not to leave high-risk children uncovered and to guide hospitals to maintain a high level of readiness.

Identifiants

pubmed: 38451927
doi: 10.1097/INF.0000000000004314
pii: 00006454-990000000-00774
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to disclose.

Références

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Auteurs

Raffaella Nenna (R)

From the Department of Maternal Infantile and Urological Sciences.

Alessandra Pierangeli (A)

Virology Laboratory, Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.

Luigi Matera (L)

From the Department of Maternal Infantile and Urological Sciences.

Laura Petrarca (L)

From the Department of Maternal Infantile and Urological Sciences.

Maria Giulia Conti (MG)

From the Department of Maternal Infantile and Urological Sciences.

Enrica Mancino (E)

From the Department of Maternal Infantile and Urological Sciences.

Greta di Mattia (G)

From the Department of Maternal Infantile and Urological Sciences.

Domenico Paolo La Regina (DP)

From the Department of Maternal Infantile and Urological Sciences.

Fabrizio Virgili (F)

From the Department of Maternal Infantile and Urological Sciences.

Paola Papoff (P)

From the Department of Maternal Infantile and Urological Sciences.

Enea Bonci (E)

From the Department of Maternal Infantile and Urological Sciences.

Fabio Midulla (F)

From the Department of Maternal Infantile and Urological Sciences.

Classifications MeSH