The increase of bronchiolitis severity in the 2022-2023 season in an Italian tertiary children's hospital: An isolated phenomenon or a warning sign?

Pediatr Pulmonol. 2024 May;59(5):1236-1245. doi: 10.1002/ppul.26891. Epub 2024 Jan 30.

Abstract

Aim: Recent literature has shown epidemiological changes in bronchiolitis with an increased incidence in the post-SARS-CoV-2 pandemic period but reports regarding disease severity are conflicting. We aimed to describe the epidemiology, disease severity, and microbiology of bronchiolitis during the 2022-2023 cold season compared to the previous 5 years.

Methods: This single-center retrospective observational study at IRCCS Gaslini, Italy, included all children aged 0-2 years hospitalized for bronchiolitis from 1 September 2017 to 31 August 2023. Findings from the 2022-2023 season were compared to the previous 5 years.

Results: We observed a statistically significant increase in the 2022-2023 season in the absolute number of bronchiolitis admissions. Children who required mechanical ventilation (MV) dramatically increased from a total of seven patients in the previous five seasons to 17 in the 2022-2023 season alone (p = .001). All other severity parameters significantly increased: the need for respiratory support (p = .002), the median length of stay (5 days vs. 4 days, p = .001), and the median duration of respiratory support (4 days vs. 3 days, p = .016).

Conclusions: We report a substantial increase in the severity of bronchiolitis in the season 2022-2023 with a remarkable number of previously healthy infants requiring MV. Further studies are needed to confirm whether our findings are an isolated phenomenon or part of a true global trend. Health systems need to be prepared and protective preventive measures should be implemented for all newborns.

Keywords: RSV; bronchiolitis; mechanical ventilation; prevention; severity.

Publication types

  • Observational Study

MeSH terms

  • Bronchiolitis* / epidemiology
  • COVID-19 / epidemiology
  • Child, Preschool
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, Pediatric* / statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Italy / epidemiology
  • Length of Stay / statistics & numerical data
  • Male
  • Respiration, Artificial / statistics & numerical data
  • Retrospective Studies
  • Seasons
  • Severity of Illness Index*
  • Tertiary Care Centers* / statistics & numerical data

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