Bronchiolitis is a common cause of hospitalization in infants. The long-lasting impact of hygiene and social behavior changes during the pandemic on this disease is debated. We investigated the prevalence of hospitalized cases, clinical severity, and underlying risk factors before and during pandemic. The study was conducted in 27 hospitals in Italy and included infants hospitalized for bronchiolitis during the following four periods: July 2018-March 2019, July 2020-March 2021, July 2021-March 2022, and July 2022-March 2023. Data on demographics, neonatal gestational age, breastfeeding history, underlying chronic diseases, presence of older siblings, etiologic agents, clinical course and outcome were collected. A total of 5330 patients were included in the study. Compared to 2018-19 (n = 1618), the number of hospitalizations decreased in 2020-21 (n = 121). A gradual increase was observed in 2021-22 (n = 1577) and 2022-23 (n = 2014). A higher disease severity (need and length of O2-supplementation, need for non-invasive ventilation, hospital stay) occurred in the 2021-22 and, especially, the 2022-23 periods compared to 2018-19. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity.   Conclusions: Compared to adults, COVID-19 in infants is often asymptomatic or mildly symptomatic and rarely results in hospitalization. This study indicates that the pandemic has indirectly induced an increased burden of bronchiolitis among hospitalized infants. This shift, which is not explained by the recognized risk factors, suggests the existence of higher infant vulnerability during the last two seasons. What is known: • The pandemic led to a change in epidemiology of respiratory diseases • Large data on severity of bronchiolitis and underlying risk factors before and during COVID-19 pandemic are scarce What is new: • Compared to pre-pandemic period, hospitalizations for bronchiolitis decreased in 2020-21 and gradually increased in 2021-22 and 2022-23 • Compared to pre-pandemic period, higher disease burden occurred in 2021-22 and, especially, in 2022-23. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity • The interplay among viruses, preventive measures, and the infant health deserves to be further investigated.

Long-lasting effects of COVID-19 pandemic on hospitalizations and severity of bronchiolitis / G.P. Milani, A. Ronchi, C. Agostoni, P. Marchisio, G. Chidini, N. Pesenti, A. Bellotti, M. Cugliari, R. Crimi, V. Fabiano, C. Pietrasanta, L. Pugni, F. Mosca, R. Barachetti, C. Pagliotta, S. Gulden, F.M. Risso, M. Colpani, S. Aversa, P. Tagliabue, F. Cattaneo, R. Corbetta, M.L. Ventura, S. Ghirardello, I. De Lucia, F. Garofoli, L. Mancini, G.A.C. Pattarino, C. De Giacomo, S. Barberi, M. Vernich, E. Veronelli, E. Brazzoduro, I. Bottino, T. Varisco, P. Calzi, A. Porta, P. Alga, L. Cozzi, F. Lizzoli, L. D’Antiga, G. Mangili, A. Mazza, F. Di Stasio, G.L. Marseglia, A. Mascolo, M. Jankovic, L. Decembrino, D. Pantaleo, C. Vimercati, M.C. Faraguna, F. Cattaneo, I. Lepri, L. Pogliani, C. Vimercati, L. Bevilacqua, L. Bernardo, S. Arrigoni, G. Mercurio, C. Paramithiotti, E. Salvatici, G. Banderali, A.F. Podestà, E. Dusi, T. Vivaldo, S. Bianchini, G. Barera, P. Del Barba, C. Aracu, S. Martinelli, A. Proto, M. Fossati, L. Rossi, E. Palumbo, M. Odoni, I. Dalla Verde, A. Kantar, P. Sindico, G. Morandi, V. Fasolato, G. Viscogliosi, N.P. Managanelli, G. Riva, C. Tzialla, R. Giacchero, C. Sabatini, E. Rossi, C.A. Ghitti, I. Pacati, R. Badolato, L. Dotta, A. Meini, I. Bresesti, A. Francone, A.M. Plebani, M. Agosti, L. Rossi, M. Sala, S. Santucci, C. Cuzzupè, C. Bellan, F. Pontiggia, A. Romero, C. Perazzi, A. Banfi, G. Zuccotti, G. Lista. - In: EUROPEAN JOURNAL OF PEDIATRICS. - ISSN 0340-6199. - (2024), pp. 1-8. [Epub ahead of print] [10.1007/s00431-023-05395-1]

Long-lasting effects of COVID-19 pandemic on hospitalizations and severity of bronchiolitis

G.P. Milani
Primo
;
A. Ronchi
Secondo
;
C. Agostoni;P. Marchisio
;
A. Bellotti;M. Cugliari;R. Crimi;V. Fabiano;C. Pietrasanta;L. Pugni;F. Mosca;R. Barachetti;S. Gulden;E. Brazzoduro;I. Bottino;A. Porta;L. Cozzi;G. Mercurio;C. Paramithiotti;E. Salvatici;E. Dusi;T. Vivaldo;S. Bianchini;A. Proto;M. Fossati;C. Sabatini;I. Bresesti;M. Sala;A. Romero;C. Perazzi;A. Banfi;G. Zuccotti
Penultimo
;
2024

Abstract

Bronchiolitis is a common cause of hospitalization in infants. The long-lasting impact of hygiene and social behavior changes during the pandemic on this disease is debated. We investigated the prevalence of hospitalized cases, clinical severity, and underlying risk factors before and during pandemic. The study was conducted in 27 hospitals in Italy and included infants hospitalized for bronchiolitis during the following four periods: July 2018-March 2019, July 2020-March 2021, July 2021-March 2022, and July 2022-March 2023. Data on demographics, neonatal gestational age, breastfeeding history, underlying chronic diseases, presence of older siblings, etiologic agents, clinical course and outcome were collected. A total of 5330 patients were included in the study. Compared to 2018-19 (n = 1618), the number of hospitalizations decreased in 2020-21 (n = 121). A gradual increase was observed in 2021-22 (n = 1577) and 2022-23 (n = 2014). A higher disease severity (need and length of O2-supplementation, need for non-invasive ventilation, hospital stay) occurred in the 2021-22 and, especially, the 2022-23 periods compared to 2018-19. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity.   Conclusions: Compared to adults, COVID-19 in infants is often asymptomatic or mildly symptomatic and rarely results in hospitalization. This study indicates that the pandemic has indirectly induced an increased burden of bronchiolitis among hospitalized infants. This shift, which is not explained by the recognized risk factors, suggests the existence of higher infant vulnerability during the last two seasons. What is known: • The pandemic led to a change in epidemiology of respiratory diseases • Large data on severity of bronchiolitis and underlying risk factors before and during COVID-19 pandemic are scarce What is new: • Compared to pre-pandemic period, hospitalizations for bronchiolitis decreased in 2020-21 and gradually increased in 2021-22 and 2022-23 • Compared to pre-pandemic period, higher disease burden occurred in 2021-22 and, especially, in 2022-23. This tendency persisted after adjusting for risk factors associated with bronchiolitis severity • The interplay among viruses, preventive measures, and the infant health deserves to be further investigated.
Bronchiolitis; Epidemiology; Immune debt; Pandemic; Risk factors
Settore MED/38 - Pediatria Generale e Specialistica
2024
18-gen-2024
Article (author)
File in questo prodotto:
File Dimensione Formato  
Eur J Ped 2024.pdf

accesso aperto

Descrizione: Online First
Tipologia: Publisher's version/PDF
Dimensione 756.65 kB
Formato Adobe PDF
756.65 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1026466
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 2
social impact