Bronchiolitis before and after the SARS-CoV-2 pandemic: Twelve years of experience in a Spanish paediatric hospital

Pediatr Pulmonol. 2023 Apr;58(4):1201-1209. doi: 10.1002/ppul.26322. Epub 2023 Jan 24.

Abstract

Introduction: Acute bronchiolitis is the main cause of hospitalization in children under 2 years of age, with a regular seasonality, mostly due to the respiratory syncytial virus.

Objectives: To describe the epidemiology of bronchiolitis hospitalizations in our center in the last 12 years, and analyze the changes in clinical characteristics, microbiology, and adverse outcomes during the SARS-CoV-2 pandemic.

Methods: Observational study including patients admitted for bronchiolitis between April 2010 and December 2021 in a Spanish tertiary paediatric hospital. Relevant demographic, clinical, microbiological, and adverse outcome variables were collected in an anonymized database. The pandemic period (April 2020 to December 2021) was compared to 2010-2015 seasons using appropriate statistical tests.

Results: There were 2138 bronchiolitis admissions, with a mean of 195.6 per year between 2010 and 2019 and a 2-4-month peak between November and March. In the expected season of 2020, there was a 94.4% reduction of bronchiolitis hospitalizations, with only 11 cases admitted in the first year of the pandemic. Bronchiolitis cases increased from the summer of 2021 during a 6-month long peak, reaching a total of 171 cases. Length of stay was significantly shorter during the pandemic, but no differences were found in clinical and microbiological characteristics or other adverse outcomes.

Conclusions: The SARS-CoV-2 pandemic has modified the seasonality of bronchiolitis hospitalizations, with a dramatic decrease in cases during the expected season of 2020-2021, and an extemporaneous summer-autumn peak in 2021 with longer duration but similar patient characteristics and risk factors.

Keywords: SARS-CoV-2; bronchiolitis; epidemiology; paediatrics; pandemics; respiratory syncytial virus (RSV).

MeSH terms

  • Bronchiolitis*
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Hospitalization
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Pandemics
  • Respiratory Syncytial Virus Infections* / complications
  • Respiratory Syncytial Virus Infections* / epidemiology
  • Respiratory Syncytial Virus Infections* / therapy
  • Respiratory Syncytial Virus, Human*
  • SARS-CoV-2