Bronchiolitis: Increased severity in the post‐COVID‐19 era

Pediatric Pulmonology, Journal Year: 2024, Volume and Issue: 59(12), P. 3197 - 3203

Published: July 11, 2024

Abstract Introduction Acute bronchiolitis is a pressing public health concern, leading to numerous infant hospitalizations worldwide annually. The notable decrease in during the COVID‐19 pandemic sparked concerns about potential resurgence post‐pandemic. Questions also arose severity of post‐pandemic cases compared prepandemic ones. This study aimed compare before and after pandemic, alongside changes epidemiology viral agents. Material Methods We conducted retrospective analysis medical records concerning infants under 12 months hospitalized for acute our pediatric pulmonology department over period 5 years: 2 pre‐COVID years (2018−2020), COVID year (2020), post‐COVID (2021−2023). Clinical laboratory data were collected using standardized forms. Results Hospital admissions exhibited comparable rates pre‐ but witnessed decline period. Post‐COVID, increased, with longer hospitalization durations ( p < 0.001) increased oxygen therapy = 0.04), coinciding surge prevalence RSV infections 0.01). Patients testing positive significantly younger 0.005) more severe symptoms. Discussion Conclusion reveals significant increase rise following pandemic. implementation preventive measures such as nirsevimab crucial alleviate burden respiratory illnesses vulnerable populations. Continued vigilance research are needed address evolving challenges era.

Language: Английский

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Hospitalizations for bronchiolitis among infants before and after the SARS-CoV-2 pandemic: an area-based study of the Emilia-Romagna Region, Italy

˜The œItalian Journal of Pediatrics/Italian journal of pediatrics, Journal Year: 2025, Volume and Issue: 51(1)

Published: Feb. 7, 2025

Abstract Background Bronchiolitis is the most frequent lower respiratory tract infection and a leading cause of hospitalization in infants. Our aim was to assess incidence characteristics bronchiolitis requiring hospital admission an Italian region before after SARS-CoV-2 pandemic. Methods This area-based retrospective study analyses 4,396 discharge records (HDR) children under 1 year age admitted with diagnosis (ICD9-CM codes 466.11 466.19), Emilia-Romagna (Italy) from January1st, 2018 December 31th, 2021. Weighted t-testing Z-testing carried out. Results period, 2–4% infants were for (10% all admissions year) 59% them aged less than 90 days. After significant decrease 2020, resurged 2021, Respiratory Syncytial Virus (RSV) cases reached 82%. RSV more likely undergo non-invasive ventilation (NIV), oxygen supplementation receive i.v. (intravenous) infusions. There overall increasing trend NIV supplementation, decreasing chest X-rays. Conclusions shows reduced due during pandemic resurgence easing preventive measures. We also provide information on length stay need treatments. These will be helpful assessing impact future universal prevention

Language: Английский

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Respiratory Syncytial Virus Epidemiology in Argentina: From COVID-19 Pandemic to the Maternal Immunization Strategy

The Pediatric Infectious Disease Journal, Journal Year: 2025, Volume and Issue: 44(2S), P. S23 - S26

Published: Feb. 1, 2025

Introduction: Worldwide, respiratory syncytial virus (RSV) is the leading cause of acute lower tract infections (LRTIs) and hospital admissions among infants young children. The COVID-19 pandemic changed epidemiology clinical patterns viruses other than severe syndrome coronavirus 2. Argentina introduced RSV maternal vaccine in 2024. This multicenter study describes clinical-epidemiological profile hospitalized pediatric patients with LRTI associated Argentina, comparing pre- postpandemic periods, identifies independent predictors infection. Materials methods: prospective, included under 18 years old admitted for 5 tertiary centers before (2018–2019) after (2022–2023) COVID-19. Changes viral detection rates, seasonality, epidemiological characteristics were analyzed. Indirect immunoassay or real-time polymerase chain reaction used virological diagnosis prepandemic postpandemic. Data analysis was performed using Epi Info 7. Results: A total 5838 cases (mean age: 9.5 months; interquartile range: 4–22 months), 96.6% tested detection, 66.4% positive (3877 cases). most prevalent virus, followed by parainfluenza influenza. Postpandemic, there a significant decrease prevalence an increase metapneumovirus infections. seasonality shifted 6 weeks forward In 2022, increased, displacing RSV, which recovered typical 2023 earlier onset. Viral coinfection occurred 17.2% cases. Globally, 71% 12 months (45.8%, <6 months); bronchiolitis common presentation (68.9%), cough (78.3%), distress (69.6%), rhinorrhea (65.9%) fever (64.7%) being symptoms. Nearly 44% had underlying conditions, 15.7% born preterm, 15% required intensive care 24% received empirical antibiotics. periods showed no age differences RSV-associated cases, but higher comorbidity prevalence, requirement antibiotic use Prematurity [odds ratio (OR): 1.3, 95% confidence interval (CI): 1.1–1.5; P = 0.004], comorbidities (OR: 1.8, CI: 1.6–2; < 0.001) 1.6–2.1; Conclusions: primarily affected 1 year old. No found between comorbidities, increased requirements use. Prematurity, conditions infection patients.

Language: Английский

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Outbreak of Post‐Infectious Bronchiolitis Obliterans (PIBO) After Adenovirus Infection: A Case Series and Review of the Literature

Pediatric Pulmonology, Journal Year: 2025, Volume and Issue: 60(4)

Published: April 1, 2025

Post-infectious bronchiolitis obliterans (PIBO) is a rare chronic pediatric pulmonary disease characterized by irreversible fibrotic narrowing of the small airways. Treatment options remain uncertain with limited success. To delineate characteristics patients diagnosed PIBO in Ljubljana (Slovenia) and Trieste (Italy) 2023. We retrospectively assessed clinical records from January to December 2023, capturing data on initial viral infection, presentation, radiological features, treatments, outcomes. In 11 were identified, contrasting only 6 cases previous 7 years. Common symptoms signs included tachypnea, wet cough, diffuse crackles following adenovirus pneumonia. Most previously healthy. Chest CT findings confirmed diagnosis all cases. Bronchoalveolar lavage showed elevated levels neutrophils (46% 90% cells), biopsies performed indicated predominantly lymphocytic inflammatory infiltrate bronchiolar fibrosis. Nocturnal pulse oximetry revealed reduced mean SpO2 (median: 96.5% Q1: 93%, Q3: 98%) lower values 89% 87%, 92.5%) an increased oxygen desaturation index (1.1 11.2 events/hour). involved methylprednisolone (20-30 mg/kg) for three consecutive days monthly months, resulting improvement nine seven patients. The post-pandemic surge may stem ecology changes, immunologic factors, and/or genotypes, highlighting need further research into its etiology management strategies.

Language: Английский

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La profilassi dell'infezione da virus respiratorio sinciziale: dal dire al fare?

Medico e Bambino, Journal Year: 2024, Volume and Issue: 43(4), P. 211 - 212

Published: April 17, 2024

Alcuni stati europei hanno introdotto la prevenzione universale con il nirsevimab risultati favorevoli, così come dimostrerebbe l’esperienza pilota della Valle d’Aosta (pag. 239). Si tratta di definire in modo molto pratico cosa fare nel panorama “nazionale” per prossima stagione.

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Changes in entire acute bronchiolitis seasons before, during, and after the COVID-19 pandemic in Spain.

Infection Prevention in Practice, Journal Year: 2024, Volume and Issue: 6(4), P. 100399 - 100399

Published: Sept. 23, 2024

Language: Английский

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Prophylaxis with palivizumab in a six‐year‐old girl with Down syndrome and postinfectious obliterative bronchiolitis

Pediatric Pulmonology, Journal Year: 2024, Volume and Issue: unknown

Published: July 29, 2024

The authors declare no conflicts of interest. data are available from the corresponding author at this mail address francesca. peri@burlo. trieste. it, upon reasonable request.

Language: Английский

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Pediatric Respiratory Infections ‎After the COVID-19 Pandemic: A Single-Center Experience

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: July 30, 2024

Background Pediatric respiratory infections, mainly bronchiolitis, are a substantial clinical burden. The most common etiology is syncytial virus (RSV). Other viruses include human rhinovirus, metapneumovirus, influenza, adenovirus, coronavirus, and parainfluenza viruses. Objective We aimed to study the epidemiology characteristics of children with confirmed viral bronchiolitis flu after COVID-19 pandemic season compare behavior each virus. Methods This retrospective observation was done over seven months, from October 2022 April 2023. All (0-14) were included in if they met diagnosis or flu. Viral by PCR, using panel available our center which detection four viruses: COVID-19, RSV, influenza A, B. Clinical data, lab results, X-rays collected correlated infection for all admitted patients. Results recruited 237 symptoms peak infections (41%) November. Seasonal variations showed distinct patterns across year. RSV peaked at beginning season, gradually declining that. In contrast, A B maintained relatively consistent presence throughout season. Meanwhile, reached its during March April. One hundred forty-four (60%) patients under two years age. predominant 150 (63.3%). only detected 25 (10%), whereas equally isolated 31 (13%) each. Fifty-one (21%) initially sick required pediatric intensive care unit (PICU) admission, no deaths reported. Notably, had milder disease course, shorter length stay (LOS) hospital (two days) duration illness (five compared other linked more profound hypoxia extended stays. Conclusion Our that, following release lockdown measures, there another upper tract (URTI) flu, aggressive, primarily due viruses, especially RSV. resurgence associated severe an increased need hospitalization. better condition those

Language: Английский

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The impact of the COVID-19 pandemic on respiratory failure caused by respiratory viruses in children and adolescents

Frontiers in Pediatrics, Journal Year: 2024, Volume and Issue: 12

Published: Aug. 15, 2024

Background In addition to the direct impact of coronavirus disease 2019 (COVID-19) pandemic on child/adolescent health, changes in infections caused by other viruses have been observed. Respiratory syncytial virus (RSV) and influenza are important agents acute respiratory failure (ARF) these age groups. This study presents an analysis influence seasonal clinical patterns ARF RSV influenza. Methods A retrospective ecological was performed. The data individuals younger than 20 years who were hospitalized with diagnosed RSV, severe syndrome 2 (SARS-CoV-2) between 2022 analysed. collected from governmental system. Results Among 367,136 individuals, incidence increased annually. During pandemic, number infected schoolchildren, adolescents, nonwhite people; intensive care admissions; mortality rates increased. Older age, SARS-CoV-2 infection, residence North Brazil/Northeast Brazil associated lower odds unit admission but greater death. Comorbidities risk factors for disease. There a drastic reduction infections, resurgence 2021. After 2021, influenza-related deaths remained above level, which did not occur 2022. infection Conclusions older children, comorbidities more vulnerable ARF. prevalence severity infections. this reduction, out-of-season pattern, without higher death prepandemic year, observed both

Language: Английский

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Exploring Risk Factors Associated With Intensive Care Unit Admission in a Retrospective Cohort of 631 Children With Bronchiolitis

Pediatric Pulmonology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 15, 2024

ABSTRACT Aim Examine the trends and epidemiological features of acute hospitalized bronchiolitis cases among children aged 28 days to 2 years, both before after COVID‐19 pandemic. Furthermore, evaluate their need for intensive care unit (ICU) admission identify primary risk factors associated with severe bronchiolitis. Methods A retrospective analysis was conducted on medical records paediatric patients admitted Meyer Children's Hospital in Florence (Italy) from September 2019 March 2023, diagnosis Results Between hospitalizations grew by 76%, going 131 230 cases, historical minimum 14 2020–2021 season. Respiratory syncytial virus (RSV) infection emerged as predominant etiological agent, contributing 76% 2021–2022 2022–2023 seasons. Coinfection increased fivefold accounting 23% 2022–2023. In addition, ICU rate 13% 2019–2020 31% Univariate multivariate data show that infants below months age, preterm births, comorbidities RSV infections were correlated a higher admission. Conclusion The growing trend admissions represents substantial health challenge. Addressing epidemic necessitates strategic focus prevention through interventions such vaccines monoclonal antibodies. Urgent implementation preventive initiatives, together continuous surveillance establishment national databases, is imperative cannot be further deferred.

Language: Английский

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